2012 Annual Report - Department of Medicine

Transcription

Department of Medicine
2012 Annual Report
University of British Columbia, Vancouver, Canada
C O NT E NT S
Message from the Chair, Department of Medicine
3
Heads & Directors
5
Committees
6
Division Reports
AIDS 10
Allergy & Immunology 25
Cardiology 28
Critical Care Medicine 31
Endocrinology 35
Gastroenterology 37
General Internal Medicine & Community Internal Medicine41
Geriatric Medicine 47
Hematology 51
Infectious Diseases 55
Medical Oncology 57
Nephrology 59
Neurology 61
Physical Medicine & Rehabilitation 65
Respiratory Medicine 67
Rheumatology 70
Office of Education 73
Education Programs
Clinical Investigator Program Experimental Medicine Graduate Program
Postgraduate Education Program Global Health Initiative
Undergraduate Education Program Discipline Site Specific Leaders (DSSL)
75
76
78
79
81
82
Research Office 89
Canada Research Chairs, Endowed Chairs & Professorships
90
Mentoring Program
105
Awards & Honours 106
Administration 109
2
UBC DEPARTMENT OF MEDICINE - ANNUAL REPORT 2012
University of British Columbia
2012 Annual Report
Graydon S. Meneilly
Professor and Eric W. Hamber Chair
Head, UBC Department of Medicine
Physician-in-Chief and Head,
Department of Medicine,
Vancouver Hospital
Contributors
Division Heads and Administrators
Program Directors and Managers
Staff & Faculty
Cover photo
Photospin
Photography
Andy Fang
M E S S A G E
F R O M
T H E
C H A I R
I am very pleased to present the 2012 annual report of the UBC
Department of Medicine. The Department of Medicine is comprised of 17 divisions with faculty members and trainees located
at numerous teaching hospitals and UBC sites throughout the
province of British Columbia. I am very proud of our department
members and their important contributions to the overall mission
of the Faculty of Medicine, and I trust that this report will provide
valuable information about our divisions and our educational and
research programs, as well as highlight some of the outstanding
work and achievements of our department members over the
past year.
I would like to take this opportunity to thank Dr. Paul Man, Associate Head, UBC Department of Medicine and Chair, Department
of Medicine at Providence Health Care, and Dr. Michael Barnett,
Associate Head, UBC and VGH Department of Medicine, for all
of their contributions. Dr. Man and Dr. Barnett are absolutely
integral to the function of the Department and all of its strategic
initiatives.
The foundation of all activities in a Department of Medicine is
exemplary patient care. Maintaining the highest quality of care
has been challenging due to resource constraints but our members continue to surpass expectations for excellence in meeting
the evolving needs of British Columbia’s citizens. The Department is currently working on implementing the integrated use
of hand-held ultrasound devices. These devices will substantially
enhance quality of care at the bedside and allow us to do procedures which we used to do routinely but have passed on to other
disciplines.
The Department has been successful in fundraising for research
activities through the VGH & UBC Hospital Foundation and the
St. Paul’s Hospital Foundation. The Department and its divisions
work closely with the hospital foundations and the UBC Faculty of
Medicine Development Office to raise funds for medical equipment, world-class research and improvements to patient care for
the many specialized areas of care in our Department. The funds
raised are vital to the success of our hospitals in delivering the
best of health care to adult British Columbians. Financial support from donors bridges the gap between the essential funding
governments provide and more advanced health care and medical
research.
Graydon S. Meneilly, MD, FRCPC, FACP
Professor & Eric W. Hamber Chair
Head, UBC Department of Medicine
3
We had two changes to executive leadership in 2012. Dr. Andrew
Krahn was appointed Head, UBC Division of Cardiology, effective
August 1, 2012. Dr. Krahn was the successful candidate for the
Sauder Family and Heart and Stroke Foundation of BC and Yukon
Chair in Cardiology, and for the Paul Brunes UBC Professorship in
Heart Rhythm Disorders. Dr. Krahn comes to UBC from the Schulich School of Medicine and Dentistry at the University of Western
Ontario. He is internationally recognized for his clinical work in
the management of cardiac arrhythmias and for his research in
investigation of genetic causes of arrhythmias, causes of loss of
consciousness and implantable arrhythmia device monitoring.
Without the generous commitments of the Heart and Stroke
Foundation of BC and Yukon, Cardiac Services BC, and the VGH and
UBC Hospital Foundation this dynamic recruitment would not have
been possible. I’d like to thank these organizations for their tremendous contributions. I would also like to express my heartfelt
thanks to Dr. Andy Ignaszewski and Dr. Ken Gin, for their hard work
and dedication as the Co-Heads for the UBC Division of Cardiology.
Dr. Gin will continue as Head of the VGH Division of Cardiology,
and Dr. Ignaszewski will continue as Head of the St. Paul’s Hospital
Division of Cardiology.
In addition, Dr. Charles Li, Clinical Associate Professor, Hematology,
has taken on the role of Chair, DOM Clinical Faculty Affairs Committee and departmental representative on the Faculty of Medicine
Clinical Faculty Affairs Committee. I would like to thank Dr. Peter
Phillips who stepped down from this role at the end of his term,
July 1, 2012, for all of his hard work on behalf of our clinical faculty.
The Department is fully committed to excellence in teaching. Our
undergraduate program was the first in North America to distribute the entire 4-year curriculum across four geographically distinct
sites including the Island Medical Program, Northern Medical Program, Vancouver Fraser Medical Program, and the Southern Medical Program (added in 2011). Enrolment has more than doubled
since we began using this unique model of distributed education
in 2004. In the postgraduate realm, we have the second largest
internal medicine training program in Canada. We continue to
attract the highest quality trainees from around the country, and
our program is becoming widely known for innovation in teaching
quality improvement. We now have over 1,200 students and core
residents disbursed across the province in over 25 sites.
Because of the significant changes the education portfolio within
the Department has experienced over the last ten years, a Task
Force was commissioned to examine current educational programs
and future directions for educational research and education in
the department in a strategic way. The Education Task Force (ETF)
presented recommendations to the executive in the areas of simulation; scholarship; student assessment; clinical skills and portable
diagnostic tools; and medical school expansion and community
engagement. A key recommendation was the need to dedicate
strategic leadership to ensure continuity of direction and progress
to sustain and advance the excellence of our education program.
The Office of Education was created in October of 2012 with Dr.
Adam Peets being appointed the Department’s first Associate
Head, Education, and Ms. Kathy Standeven taking on the role of
Senior Manager, Education.
As we look towards the future, the most significant challenge facing the Department continues to be the lack of a stable alternative
funding plan to fund its academic mission. Successful implementation of an AFP/practice plan is the Department’s most critical
mission. In addition, the Department would ultimately like to
create a province-wide system for clinical care, teaching and health
services research that will best serve the needs of British Columbians.
In closing I would like to take this opportunity to once again acknowledge the contributions of all faculty and staff and to thank
them for their dedication and contributions to the success of the
Department of Medicine.
4
EXECUTIVE COMMITTEE
HEADS & DIRECTORS
DEPARTMENT HEADS
Graydon S. Meneilly, MD, FRCPC, FACP
Professor and Eric W. Hamber Chair
Head, Department of Medicine, University of British Columbia
Head, Department of Medicine, Vancouver Hospital
S. F. Paul Man, MD, FRCPC
Chair, Department of Medicine
Providence Health Care
UBC Associate heads
Dr. Michael Barnett, Associate Head of Medicine, Vancouver Acute
Dr. S. F. Paul Man, Associate Head of Medicine, Providence Health Care
Dr. Teresa Tsang, Associate Head, Research
Dr. Adam Peets, Associate Head, Education
ubc division heads
AIDSDr. Julio Montaner
Allergy & Immunology
Dr. Robert Schellenberg
Cardiology
Dr. Andrew Krahn (as of August 1, 2012)
Community Internal Medicine
Dr. Barry Kassen
Critical Care Medicine
Dr. Najib Ayas
Endocrinology
Dr. Ehud Ur
Gastroenterology
Dr. Eric Yoshida
General Internal Medicine
Dr. Barry Kassen
Geriatric Medicine
Dr. Maria Chung (Interim UBC/VGH Head)
Dr. Amanda Hill (Interim UBC/SPH Head)
Hematology/Bone Marrow Transplantation
Dr. Michael Barnett
Infectious Diseases
Dr. Peter Phillips
Medical Oncology
Dr. Joseph Connors (Interim)
Nephrology
Dr. Adeera Levin (UBC Head)
Dr. Jacek Jastrzebski (VGH Head)
Neurology
Dr. Jon Stoessl
Physical Medicine & Rehabilitation
Dr. Andrea Townson
Respiratory Medicine
Dr. J. Mark FitzGerald
Rheumatology
Dr. Kamran Shojania
educational program directors
Clinical Investigator Program
Dr. Anita Palepu Graduate Studies Program in Experimental Medicine
Dr. Vince Duronio
Postgraduate Education Program
Dr. J. Mark Roberts
Undergraduate Education Program
Dr. Janet Kushner-Kow
Director, Educational Research & Scholarship
Dr. Kevin Eva
Clinical Faculty Representatives Committee Chair
Dr. Charles Li
5
DEPARTMENT OF MEDICINE STANDING COMMITTEES
COMMITEE FOR APPOINTMENTS, REAPPOINTMENTS, PROMOTION & TENURE
CHAIR Dr. G. S. Meneilly, Professor
VICE-CHAIRDr. S. F. Paul Man, Professor
ADMINISTRATIVE SUPPORT
Jeannie Brown
COMMITTEE MEMBERS Dr. Najib Ayas, Associate Professor, Critical Care Medicine
Dr. Michael Barnett, Clinical Professor, Hematology Dr. Jeff Beckman, Clinical Associate Professor, Neurology
Dr. William Bowie, Professor, Infectious Diseases
Dr. John Cairns, Professor, Cardiology
Dr. Edward Conway, Professor, Hematology
Dr. Marshall Dahl, Clinical Associate Professor, Endocrinology
Dr. John Esdaile, Professor, Rheumatology
Dr. Sharlene Gill, Associate Professor, Medical Oncology
Dr. Richard Harrigan, Associate Professor, AIDS
Dr. Donna Hogge, Clinical Professor, Hematology
Dr. Karin Humphries, Associate Professor, Cardiology
Dr. David Kendler, Clinical Associate Professor, Endocrinology
Dr. Paul Keown, Professor, Nephrology
Dr. Robert Levy, Professor, Respiratory Medicine
Dr. Robert Schellenberg, Professor, Allergy & Immunology
Dr. Jean Shapiro, Clinical Professor, Nephrology
Dr. Kamran Shojania, Clinical Professor, Rheumatology
Dr. Sandra Sirrs, Clinical Associate Professor, Endocrinology
Dr. Andrea Townson, Clinical Associate Professor, Physical Medicine
Dr. John Wade, Clinical Associate Professor, Rheumatology
Dr. Eric Yoshida, Professor, Gastroenterology
This dedicated group of committed Departmental members is charged with facilitating the career advancement of our members
while upholding consistent and rigorous standards as set out by UBC. As usual, this Committee invested a great deal of thoughtful
energy to support the additions and promotions listed below. We are very proud of the following:
NEW APPOINTMENTS
Start Dates Between January 1, 2012 and December 31, 2012
Clinical Instructor
Ambler, Kimberley - Hematology
Blake, Erin - General Internal Medicine
Chapman, Michael - Infectious Diseases
Das, Sharmistha - General Internal Medicine
Forzley, Brian - Nephrology
Ghosh, Surajit - General Internal Medicine
Hawkeswood, Jonathan - Physical Medicine & Rehabilitation
Hsu, Tina - Medical Oncology
Kerrie, Jeff - General Internal Medicine
Lee, Julian - Neurology
Li, Anson - Geriatric Medicine
Lo, Lawrence - Geriatric Medicine
McGhie, John - Medical Oncology
Prasad, Shailendra - General Internal Medicine
6
Prchal, David - Nephrology
Schroeder, Benjamin - Endocrinology
Severin, Naomi - Endocrinology
Singham, Janakie - Gastroenterology
Yao, Shaoyee - Nephrology
Yip, Todd - Physical Medicine & Rehabilitation
Clinical Assistant Professor
Abdalla, Abdalla - Community Internal Medicine
Andrade, Jason - Cardiology
Bhagirath, Kapil - Cardiology
Boldt, Camilla - Hematology
Calder, Jill - Physical Medicine & Rehabilitation
Deyell, Marc – Cardiology
Farah, Myriam - Nephrology
Gurjal, Anagha - Medical Oncology
Henri-Bhargava, Alexandre – Neurology
Hrazdil, Chantelle - Neurology
Keith, Bruce - Medical Oncology
Ksienski, Doran - Medical Oncology
Kydd, Alison - Rheumatology
Lai, Wayne - Neurology
Manjoo, Priya - Endocrinology
Michaud, Marie - Nephrology
Mills, Patricia - Physical Medicine & Rehabilitation
Mosewich, Russell - Neurology
O’Dwyer, Robert - General Internal Medicine
Olsen, Sharla-Rae - Respiratory Medicine
Power, Maryse - Hematology
Sarbit, Jay - General Internal Medicine
Segal, Samantha - Community Internal Medicine
Voyer, Stephane, - General Internal Medicine
Wong, Christopher - Infectious Diseases
Zhang, Chi - Nephrology
Clinical Associate Professor
Karr, Gerald - Community Internal Medicine
Lee, Phil - Geriatric Medicine
Peets, Adam - Critical Care Medicine
Assistant Professor
Asdaghi, Negar – Neurology
Milnerwood, Austen – Neurology
Poon, Art - AIDS
Renouf, Daniel – Medical Oncology
Sadatsafavi, Mohsen – Respiratory Medicine
Associate Professor
Hatala, Rose – General Internal Medicine
Jones, Charlotte – Endocrinology
Professor
Coppes, Max – Medical Oncology
DeWitt, Dawn – General Internal Medicine
Krahn, Andrew – Cardiology
Wood, Evan – AIDS
Associate Member
Coxon, Harvey – Respiratory Medicine
Eves, Neil – Respiratory Medicine
Farrer, Matthew – Neurology
Sharpe, Robert – Critical Care Medicine
Vu, Erik - Critical Care Medicine
Leung, Victor – Infectious Diseases
Associate Member, External
Beg, Mirza Faisal – Neurology
Guaraldi, Giovanni - Medicine
PROMOTIONS
Bell, Kathryn - Geriatric Medicine
Ervin, Frank - General Internal Medicine
Fava, Craig - Critical Care Medicine
Ho, Jin Kee - Gastroenterology
Kherani, Raheem - Rheumatology
7
Lee, Julie - Endocrinology
Petrossian, Caroline - Geriatric Medicine
Rao, Sanjay - Medical Oncology
Reebye, Rajiv - Physical Medicine & Rehabilitation
Reynolds, Jennifer - Rheumatology
Townsend, Tiffany - Neurology
Willms, Rhonda - Physical Medicine & Rehabilitation
Zandieh, Iman - Gastroenterology
Arseneau, Ric – General Internal Medicine
Aymong, Eve – Cardiology
Chan, Albert – Cardiology
Chatur, Nazira – Gastroenterology
Hawley, Pippa – General Internal Medicine
Henderson, William – Critical Care Medicine
Holmes, Cheryl - Critical Care Medicine
Jaffer, Shahin – Community Internal Medicine
Kennecke, Hagen - Medical Oncology
Lam, Eric – Gastroenterology
Song, Kevin – Hematology
Sreenivasan, Gayatri – Hematology
Walker, Shannon – Community Internal Medicine
Wong, Steve - General Internal Medicine
Clinical Professor
Beckman, Jeff – Neurology
Dahl, Marshall – Endocrinology
Associate Professor
Carlsten, Christopher - Respiratory Medicine
Tebbutt, Scott - Respiratory Medicine
Traboulsee, Anthony - Neurology
Professor
Eva, Kevin – General Internal Medicine
Harrigan, Richard – AIDS
REAPPOINTMENTS - effective July 1, 2012
Assistant Professor
Shannon, Kate - AIDS
EMERITUS
Professor Emeritus
Oger, Joel - Neurology
Clinical Professor Emeritus
Jones, Michael – Neurology
STANDING COMMITTEES
MENTORING ADVISORY COMMITTEE
for academic stream faculty standing for periodic review for
promotion and/or tenure.
The Mentoring Advisory Committee has overall responsibility
for the Department of Medicine Mentoring Program, which
operates within and is complementary to the Faculty of
Medicine Mentoring Program.
The members of the committee are: Dr. James Busser, UBC
Division of General Internal Medicine and Ms. Jeannie Brown
Faculty Hires and Promotions Coordinator, UBC Department of
Medicine. The committee reports to the Department Head.
The members of the committee are: Dr. John Cairns, Chair,
Dr. S. F. Paul Man, Dr. John Mancini, Dr. Anita Palepu, Dr. Neil
Reiner, Ms. Jeannie Brown, and Ms. Sabina Fitzsimmons.
RESIDENCY TRAINING COMMITTEE (RTC)
The Committee liaises with the Executive Committee and the
Promotion and Tenure Committee as needed. The Committee
members serve as an advisory group to the Committee chair
and assist the chair as requested, in Program development and
management.
The Chair of the Mentoring Committee works closely with
the Department Head to ensure that effective mentoring
relationships are established and maintained for every new
tenure track and grant tenure track department member from
the time of their appointment through to their achievement of
tenure and promotion to associate professor. The Committee
ensures that every mentor-mentee relationship is documented
and is functioning satisfactorily, and if not, that a new mentor is
appointed.
The Department Mentoring Program was established by Dr.
Norman Wong in January 2005. Dr. John Cairns assumed the
role of Director in July 2010. The mentoring Committee held
its first meeting in June, 2010 and since then has worked hard
to interpret the findings of the Department Research Task
Force, and to implement changes to sustain and strengthen the
Mentoring Program. The website has been much improved and
made readily accessible. All materials needed to support the
mentors and mentees are readily available on the Department
website, and documentation is now possible without the
creation, storage or transmission of paper documents.
We reached a peak of 27 mentor-mentee pairs in the Program
and there are now 24 as some of our mentees have moved on
after achieving promotion and tenure.
Every Mentor-Mentee relationship has been reviewed
and where necessary, rejuvenated, sometimes with the
appointment of a new mentor. We have worked to ensure that
a mentor is designated by the completion of the recruitment
process.
Ongoing, regular review and assessment of the Program is
planned, with the intent to implement change as needed.
TEACHING EFFECTIVENESS COMMITTEE
The Teaching Effectiveness Committee reviews teaching dossier,
CV and other back-up information and prepares an integrated,
draft teaching summary letter for the Department Head.
The teaching summary letter is used as part of the dossier
8
The Internal Medicine Residency Training Committee is
responsible for all aspects of the Postgraduate Training
Program in internal medicine in the Department of Medicine.
This responsibility is delegated from the UBC Faculty of
Medicine through the office of the Postgraduate Dean. Specific
responsibilities include selection, evaluation, and promotion of
residents, as well as provision of an educational program that
meets the standards of the RCPSC or CFPC. The Committee
strives to supervise and provide leadership in all aspects of
Postgraduate Clinical Education in the specialty of internal
medicine within the UBC Faculty of Medicine and its affiliated
teaching hospitals. The Committee meets monthly or as
required. The RTC is chaired by the Program Director and
membership is comprised of faculty members from
the divisions, residents from each year of the program, and
administrative staff.
UNDERGRADUATE EDUCATION COMMITTEE
The Internal Medicine Undergraduate Education Committee
(hereafter: “UEC”) is a monthly standing committee
reporting to the Head, UBC Department of Medicine; the MD
Undergraduate Year 3 Committee; the MD Undergraduate
Year 4 Committee; and the Years 3 and 4 Student Promotions
Committee. It is responsible for planning, implementing and
evaluating the Year 3 Internal Medicine clerkship rotation and
Year 4 electives across all three sites: Island Medical Program
(IMP), Northern Medical Program (NMP) and the Vancouver
Fraser Medical Program (VFMP). The Committee is chaired
by the Postgraduate Program Director and membership is
comprised of associate directors, faculty representatives
from each distributed site, students from each year at each
distributed site, and several non-voting members including the
Head of Medicine and several representatives from each of the
distributed sites. The committee meets monthly or as required.
CLINICAL FACULTY AFFAIRS COMMITTEE
The Department of Medicine Clinical Faculty Affairs Committee
is chaired by Dr. Charles Li, who took over from Dr. Peter
Phillips who completed his term as Chair on June 30, 2012.
Membership consists of a clinical faculty representative from
each division. The committee meets quarterly to discuss
academic policy concerns of the clinical faculty as they relate
to appointment and promotion, remuneration and rewards,
faculty development, Department of Medicine representation
and other issues of this nature. The Chair reports back to the
departmental executive on these issues. Dr. Li also represents
STANDING COMMITTEES
the department on the Faculty of Medicine Clinical Faculty
Affairs Committee, and reports back to the departmental
executive on the activities of this committee as well.
AWARDS COMMITTEE
The Awards Committee is chaired by Dr. Graydon Meneilly
and the members are Drs. Paul Man, John Fleetham, and Kam
Shojania. The committee meets quarterly to review upcoming
award competitions and identify appropriate nominees and
nominators from the Department. Our faculty
members receive numerous awards each year in recognition of
excellence in teaching, research, patient care and service.
RECRUITMENT AND RESOURCES COMMITTEE
This committee was created to oversee the strategic directions
of all future academic faculty recruitments within the UBC
Department of Medicine while ensuring that recruitment
resources are maximized. The committee meets monthly or ad
hoc as required. The Committee is co-chaired by Drs. Graydon
Meneilly and Paul Man, and members are Dr. Jon Stoessl, Dr.
Mark Fitzgerald, Dr. Teresa Tsang, Nicholas Sidorenko, Mary
Liu, Jeannie Brown and Amy Tsang (Faculty of Medicine Dean’s
Office representative).
EQUITY COMMITTEE
The Equity Committee was created in late 2009 to ensure that
the department’s search and hiring processes are equitable and
to advise the executive and recruitment committees on equity
issues affecting the department and its faculty members. The
committee meets quarterly. Committee members are Dr.
Graydon Meneilly (Chair), Dr. Anita Palepu, Dr. Kam Shojania,
Dr. Andrea Townson, Ms. Linda Rasmussen, Ms. Amy
Stanley and Ms. Donna Combs.
EXECUTIVE COMMITTEE
The Executive Committee is chaired by the Department Head
and its membership consists of the associate heads, division
heads, program directors, and administrative management
team. The committee meets monthly to share departmental,
university and other related business with members; engage
in strategic planning; create goals and objectives to continue
to strengthen the Department of Medicine; and to vote on
specific issues.
9
AIDS
of TasP in Puerto Rico. Finally, in collaboration
with the Clinton Health Access Initiative (CHAI)
we are supporting the implementation of TasP in
Swaziland. In April 2012, the Division hosted the
2nd International TasP Workshop in Vancouver.
The 3rd International TasP Workshop will be held
in Vancouver in April 2013.
Division Members
Professor
Dr. Julio S.G. Montaner
Dr. P. Richard Harrigan
Dr. Evan Wood
Associate Professor
Dr. Thomas Kerr
Assistant Professor
Dr. Viviane Dias Lima
Dr. David Moore
Dr. Art Poon
Dr. Kate Shannon
Dr. Mark W. Hull
Associate Members
Dr. Richard Lester
Dr. Iain Mackie
Dr. Val Montessori
Dr. Melanie Murray
Dr. Peter Phillips
Dr. Natasha Press
Dr. Robert Reynolds
Staff
Kelly Hsu, Administrator
Drs. Montaner and Hull continue to conduct
a randomized clinical trial to evaluate the
role of contingent reinforcement in the
engagement and retention of drug users in
HAART programs (2011-2016 NIDA grant). This
effort comes at a critical time given the many
new international initiatives aiming to increase
access and adherence to HAART among drug
users and other marginalized populations. An
Dr. Julio Montaner
important part of the STOP HIV/AIDS project,
Professor and Head
this randomized controlled trial is aimed at
improving HAART uptake among hard-to-reach
populations in Vancouver’s Downtown East
DIVISION OVERVIEW
Side and elsewhere, using a novel strategy
based on financial incentives. Phase I of this
From its inception in 2007, the Division of AIDS
study has now been completed and the results
has worked collaboratively with the BC Centre for
Excellence in HIV/AIDS (BC-CfE) (est. 1992) and the will be presented at the 3rd International TasP
Workshop. In essence, our results demonstrate
AIDS Research Program at St. Paul’s Hospital/UBC
(est. 1987). Our divisional members are involved in that modest financial incentives can have a
various areas of research, which are highlighted as dramatic effect in enhancing rates of completion
of HIV testing.
follows.
Under Dr. Montaner’s leadership, the “STOP
HIV/AIDS in BC” (Seek and Treat for Optimal
Prevention of HIV/AIDS in British Columbia) pilot
has successfully expanded HIV testing and access
to HIV/AIDS therapy in BC, with a particular focus
on street-involved populations in Vancouver’s
downtown eastside and Prince George. The initiative
has been associated with a marked decrease in
HIV new diagnoses (despite steady increases in
other STIs and stable rates of HCV infection), as
well as marked decreases in HIV/AIDS morbidity
and mortality. This work is supported in part by
the Provincial Government, and an Avant Garde
Award from the National Institute for Drug Abuse
(NIDA) at the National Institutes of Health (NIH).
“HIV Treatment as Prevention” continues to gather
international recognition as a key strategy to control
HIV & AIDS. In 2011 TasP was selected by Science
as the #1 Scientific Breakthrough. Based on the
success to date of the STOP HIV/AIDS initiative, the
Ministry of Health has announced long-term funding
($20M per year) to expand the initiative to the rest
of the province starting in April 2013. In addition,
we are currently supporting the implementation
and evaluation of Treatment as Prevention (TasP)
in China, in collaboration with the China Center for
Disease Control and NIDA. Also, in collaboration
with NIDA, we are supporting the implementation
10
In 2012, we successfully recruited Dr. Art Poon
to our Division. Since the start of Dr. Poon’s
tenure in March, he was recently awarded a
Michael Smith Foundation for Health Research
(MSFHR) / St. Paul’s Hospital Foundation Providence Health Care Research Institute
(SPHF-PHCRI) Career Investigator Scholar Award.
He is principal investigator on a CIHR operating
grant on reconstructing the evolution of HIV
within patients from next-generation sequencing
data, and is a co-investigator on seven grants
currently being funded by CIHR or NIH. He has
maintained a high level of academic productivity
with a total of 40 peer-reviewed publications,
over eight of which appeared in high-impact
journals such as PLoS Computational Biology and
Clinical Infectious Diseases. Dr. Poon is training
two postdoctoral fellows and two undergraduate
research assistants in 2012 who were supported
by awards from the UBC Centre for Blood
Research and SFU Office of the Vice-President
of Research, respectively. As a direct result of
his supervision, a postdoctoral fellow and an
undergraduate from Dr. Poon’s group were both
recently awarded with Young Investigator Awards
at the 20th Conference on Retroviruses and
Opportunistic Infections and invited to present
their work at this prestigious conference. In
addition, Dr. Poon was a committee member for a PhD student
at the Department of Experimental Medicine at UBC and an
MPH student at the Faculty of Health Sciences at SFU.
Drs. Thomas Kerr and Evan Wood are the Co-Directors of the
Urban Health Research Initiative (UHRI). UHRI is a program
within the BC-CfE and is affiliated with St Paul’s Hospital and
UBC and receives peer-reviewed grants from CIHR, NIH and
the Michael Smith Foundation. They also receive funding from
Foundation Open Society Institute and MAC AIDS Fund. All
research conducted by UHRI is ethically approved by the UBC/
Providence Health Care Research Ethics Board and community
advisory board.
UHRI’s mission is to improve the health of individuals and
communities through complex and appropriate health,
legal, and political research to inform policy. The respect
and protection of human rights, particularly of marginalized
populations, are key to their guiding principals and through
working with healthcare professionals, policy-makers, and
other community members ensure that rigorous scientific
investigation is done with an ethical obligation and drive the
best available scientific evidence.
rotations (approved by UBC undergrad) for medical students and
residents.
Dr. Wood continues to spearhead Stop the Violence BC (www.
stoptheviolencebc.org), a coalition of academics, past and
present members of law enforcement and others calling for
cannabis to be governed by a strict regulatory framework aimed
at limiting public health harms while also starving organized
crime of the profits they currently reap as a result of cannabis
prohibition. This recent initiative has received significant
public and media interest and has stimulated a lively debate
among political leaders, other policy makers and the general
public throughout the province and beyond. In promoting the
coalition’s aims, Dr. Wood has conducted public forums and
has met with teachers, MLAs, MPs, BC’s public health officers,
members of the Assembly of First Nations, the Vancouver Board
of Trade and others. To date, the goals of Stop the Violence BC
have been endorsed by four of Vancouver’s former mayors and
four former BC Attorneys General, among many others, and the
initiative continues to generate interest and support.
Most recently, Drs. Montaner, Kerr, and Wood were the
recipients of the Queen Elizabeth II Diamond Jubilee Medal from
the Governor General of Canada, which honours the significant
UHRI also hosts an undergraduate elective for 4th year medical contributions and achievements they have made in the area of
students. The elective provides clinical and research encounters HIV/AIDS and addiction.
in the broad area of urban health.
Dr. Kate Shannon is Director of the Gender and Sexual Health
Initiative (GSHI), a program of research of the BC-CfE and
The researchers continue to benefit from long-term analyses
affiliated with UBC, and supported by peer-review research
emerging from VIDUS, SEOSI, ACCESS, and ARYS. A major
grants from CIHR, US NIH, MSFHR and the MAC AIDS Fund.
focus has been the evaluation of the supervised injection
GSHI continues to evaluate and inform interventions focused on
site in the Downtown Eastside of Vancouver that is a key
sexual health and HIV/AIDS among marginalized populations,
intervention in a comprehensive approach to reducing HIV
both in Canada and globally. GSHI bridges public health, policy,
and Hepatitis C transmission in this community. Recently, in
social epidemiology, and qualitative research and aims to move
partnership with Dr. Kate Shannon, Dr. Kerr was also awarded
forward evidence-based and gender-focused HIV prevention,
a research-operating grant from NIH to initiate a program of
treatment and care. In addition to continued longitudinal
ethno-spatial epidemiology. They have also worked with the
Western Aboriginal Harm Reduction Society (WAHRS) to develop evaluations of women (AESHA I) and youth (AESHA II) engaged in
sex work in Metro Vancouver, GSHI investigators are evaluating
an interdisciplinary Community Based Research partnership
a number of local policy and program initiatives shaping risk
focused on generating evidence specific to experiences of
Aboriginal people who use drugs in HIV and addiction treatment of HIV/STI acquisition and access to HAART locally, including
supportive housing initiatives operated by Raincity Housing
(funded by CIHR).
and ATIRA. These projects involve longstanding partnerships
with many community agencies (including WISH Drop-In Centre
In an international setting, continued collaborations with the
Society, Sex Workers United Against Violence and PACE Society).
Thai AIDS Treatment Action Group (TTAG), Mitsampan Harm
Reduction Centre (Bangkok) and researchers from Chulalongkorn With an interdisciplinary and international team, the GSHI also
University have led to over 16 publications since beginning this remains committed to assessing the links between gender,
work in 2008. These works have identified numerous drivers of violence and HIV, and has recently expanded efforts focused
drug-related harms, including police abuses, incarceration, and on HIV+ women within Vancouver. On an international front,
problems with access to effective HIV prevention interventions the GSHI team continues to collaborate with The AIDS Support
Organization (TASO) in Uganda as part of the Gulu Youth Sexual
(e.g., syringe exchange and HIV testing). Through this project
we also documented an innovative community-based research Health Project focused on HIV prevention, treatment and care
methodology that involved people who inject drugs in all phases for women living with HIV and youth sex workers.
of an observational research project.
In 2012, the GSHI team was awarded a community grant by the
MAC AIDS Fund, which is investigating the sexual health and
In 2012, Dr. Wood received a $3,000,000 donation from
HIV risk environment of youth/young men in the sex industry,
Goldcorp Inc to create an interdisciplinary addiction medicine
fellowship at UBC / St. Paul’s Hospital. Details of the fellowship including MSM. This work will be completed in partnership
with HUSTLE/HiM and others. The last year also included
are available on its website (www.addictionfellowship.org).
greater focus on longitudinal research of the physical, social
Dr. Wood has also helped create addiction medicine elective
11
and structural features of the street and indoor sex work
environment. The GSHI team also continues to consult with the
World Health Organization and UNAIDS agencies, and in 2012,
Dr. Shannon sat on the WHO/UN guidelines committee for HIV/
STI prevention and treatment among sex workers (international
guidelines report was launched in December 2012).
In early 2012, the Positive Living Society of BC nominated Dr.
Shannon for the Science/Health Promotion AccolAIDS award.
The work of the GSHI garnered much media attention in the
past year, particularly in relation to the publication of research
surrounding unsanctioned safer indoor sex work environments.
Thirteen of these publications have been submitted by Dr
Shannon as expert to the Supreme Court of Canada in relation
to challenging the unintended negative effects of Canada’s
prostitution laws on sex workers’ health and access to care.
HIV Virology as well as the CIHR/GSK Research Chair in HIV/AIDS
at UBC. For more than a decade, Dr. Harrigan has been a local,
national, and international leader in the development of cuttingedge translational research with important implications for the
clinical management of HIV. He has contributed extensively to
our understanding of HIV drug efficacy and resistance, as well
as the human and viral parameters that influence HIV disease
progression. Dr. Harrigan’s research in these areas has played a
key role in enabling the significant improvements in quality and
duration of life afforded patients by Highly Active Antiretroviral
Therapy (HAART).
HIV infection is characterized by a continuous, dynamic
evolution of the viral population as it adapts to its environment
as a result of host genetic factors and antiretroviral drug
pressure. These parameters are insufficiently understood,
and their investigation in a “real world” clinical setting can
complement randomized clinical trials and prove particularly
GSHI continues to host an undergraduate Research Elective in
useful for determining longer-term outcomes. Recently, Dr.
Sexual Health for 4th year medical students at UBC, including
Harrigan developed a new test using genetic sequencing
both research and clinical encounters.
methods to identify HIV-positive individuals who will respond
to maraviroc, the first approved “CCR5 antagonist” drug. The
Dr. David Moore oversaw the presentation of the results of
Highly Active Antiretroviral therapy as Prevention (HAARP) study BC-CfE test has been adopted as the standard test across Canada
and in 16 other countries worldwide.
at the International AIDS Conference in Washington DC in July
2012. This 3-year study was conducted in partnership with the
AIDS Support Organisation, a Uganda care and treatment NGO Dr. Harrigan collaborated in the development of ReCALL
Software which allows for rapid HIV gene sequence processing
and the Uganda Virus Research Institute/ Medical Research
much in the way that Gene Code’s Sequencer software or
Council (UK) AIDS Research Unit. Dr. Moore also received
CodonCode’s Aligner software does. ReCALL has been made
funding from CIHR for a five-year project examining the effect
of unrecognized viremia on the response to second-line ART in to require less work from person using it with features such as
automatic sample parsing, sequence alignment and assembly,
Uganda. Dr. Moore continues to participate in the activities of
automated base calling and quality analysis. It also allows for
the Canada Africa Prevention Trials Network where he heads
quick visual analysis of potential problem areas. Also ReCALL
the Training Committee whose primary function is to award
is optimized for analysis of key HIV genes involved in drug
scholarships and mentorship grants to developing researchers
resistance and tropism. WebRecall software is provided free of
in East and Southern Africa. Lastly, Dr. Moore is a co-PI on a
new CIHR- and NIH-funded study to examine the effects of ART charge and to date has 148 registered users worldwide.
expansion in BC on HIV risk behaviour and community viral
load among men who have sex with men in Vancouver, known TEACHING
as the Momentum Study. Momentum began enrollment of
participants in February 2012 using a relatively novel approach CONTINUING MEDICAL EDUCATION (CME)
to recruitment known as Respondent Driven Sampling.
With the Division’s commitment and contribution, the BC-CfE
has provided several CME events:
Dr. Viviane Dias Lima has been a member of our division since
2011. The year 2012 was very productive for Dr. Lima. She
received a career award from the Michael Smith Foundation of • Semi-annual HIV Updates: These are day-long lectures
Health Research and an operating grant from CIHR, entitled HCV
where experts in clinical, epidemiological and basic science
Treatment as Prevention among HIV Co-Infected Individuals:
present HIV-related issues. CME credits from the College of
Great Promise and Big Challenges. In 2012, she published
Family Physicians are provided.
10 manuscripts in high-impact journals with a total of 74
• AIDS Care Rounds are presented every two weeks
publications since 2006. She is a co-investigator in 6 operating
by experts in the different disciplines involved in the
grants from NIH/NIDA and from CIHR, the committee member
management of HIV positive patients. CME credits are also
of two PhD students from the Department of Experimental
provided.
Medicine at UBC and from the Department the Health Sciences • IDC Journal Clubs are held every two weeks where recent
at The Mexican National University, and the thesis supervisor
relevant articles are discussed.
of a student at the Statistical Department at UBC. She currently • Mortality and Morbidity (M&M) Rounds are held once a
supervises two research assistants and four MSc-level
month at the AIDS Ward.
statisticians.
• Forefront lectures held once a month where experts in
areas of epidemiology, basic sciences, and other related
Dr. Richard Harrigan is the Director of Research Labs with the
fields are invited for presentation.
BC-CfE and also holds the Glen Hillson Professorship in Clinical
12
Also, on-site training programs are provided to physicians,
residents and medical student. A 24/7 support line is available,
also know as the REACH Line, for community health care
providers who have questions regarding the management of HIV
positive patients. More recently, the BC-CfE has developed an
Intensive HIV Preceptorship Training Program, based at St. Paul’s
Hospital, for nurse practitioners and family physicians where
they can access intense training for the management of HIV
patients. The following trainees have gone through this program
in 2012:
Intensive Preceptorship (Physicians and Nurse Practitioners)
Kim Barber, MD (Vancouver Coastal Health)-Pender Clinic/IDC
Glenn Bowlsby, MD (Vancouver Coastal Health)-Vancouver
Native Health
Kathleen Dann, MD (Vancouver Coastal Health)-3 Bridges
Monica Gregory, NP (Vancouver Coastal Health)- Downtown
Eastside
Karen Hossack, MD (Vancouver Coastal Health)-Pender
Community Health Clinic
David Joyce, MD (Vancouver Coastal Health)- Pender Community
Health Clinic
Ardelle Komaryk, NP (Vancouver Coastal Health)-Ravensong
Sylvia Makaroff, MD-BC Centre for Disease Control
Kirsten Marr, NP (Vancouver Coastal Health)-Pender Clinic
Shelliza Mohammed, MD (Vancouver Coastal Health)- Vancouver
Native Health
Susan Nouch, MD (Vancouver Coastal Health)-Pender Clinic/
Bridge Clinic/Vancouver Detox
Julian Ospina, MD (Vancouver Coastal Health)-Downtown
Community Health Centre/Pender Clinic/3 Bridges
Christina Romulus, MD (Vancouver Coastal Health)-Locum
Poornima Senra, MD (Vancouver Coastal Health)-VCH Addictions
Team
Cassandra Smith, MD (Vancouver Coastal Health)- Pender
Rochelle Stimpson, - BC Centre for Disease Control
Manal Tanyous, MD (Vancouver Coastal Health)-Vancouver
Detox/Downtown Community Health Centre
Elaine Wynne, MD (Vancouver Coastal Health)-Pine Clinic
R3 Enhanced Skills
Simon Moore-Global Health
Kimberly Rutherford-HIV
Andrea Szewchuk-Global Health
Family Practice Residents-UBC
Stephanie Bourdeau-R2
Sebastian King-R2
Lisa Lange-R2
Sheela Mistry-R2
Nitasha Puri-R2
Kim Rutherford-R2
Andrea Szewchuk-R2
Nurse Practitioner
Sara Pape-Salmon-Vancouver Island Health Authority
Other disciplines
13
Ramesh Saeedi-PGY3, Medical Biochemistry, UBC
Irina Sekirov-R1, Medical Microbiology, UBC
Short-term (physicians for 1-3 days)
Sophie Patterson-IMG from UK
Steven Yau, MD-IDC locum training
Out of Province/Country
Raphael Nepomuceno-R3, Global Health, University of Calgary
Larissa Pawluck, MD (Family Practice)-Saskatoon Community
Clinic
Steven Persaud-Yr4, MUS, University of Calgary
Catherine Verrault-Yr4, MUS, University of Ottawa
Med Student
Becky Chen-Yr4, MUS, Public Health
Christopher Cheung-Yr4, MUS, Public Health
Anna Hayden-UBC
Laura Haley-Yr1, MUS, UBC
Daniel Heffner-Y4, MUS, Public Health
Ryan Herriot-Yr4, MUS, Public Health
Erika Mehl-Yr4, MUS, Public Health
Steven Persaud- Public Health
Natalie Taha-Elective in sexual health, c/o Gender & Sexual
Health Initiative
Catherine Verreault-Public Health
UBC Infectious Diseases/Internal Medicine Residents/Fellows
UBC ID Residency Training Program (1 block full-time training at
outpatient clinics)
LeeAnne Luft-Fellow, Infectious Diseases
Sporadic training:
Khalid Al Enezi-R1
Mazen Badawi-R2
Katherine Beadon-Resident, Neurology
Mike Bevilacqua-R2
Bradly Biagioni-R2
Liam Brunham-Fellow, General Internal Medicine
Tessa Chaworth-Musters-R1
Valerie Cheung-R1, Neurology
Natasha Dehghan-R3
Nadia Fairbairn-R1
Michael Farrugia-R3, Global Health
Carla Fast-R2
Georgia Geller-R1
Natalia Golishevski-R3
Claire Harris-R1
Tom Havey-Fellow
Abraam Isaac-R2
Calvin Ke-R1
Jasmine Kler-R2
Siddharth Kogilwaimath-R3, Memorial
Clement Kwok-R2, Calgary
Morgan Lam-R1
Aleksandra Leligdowicz-R2
Caroline MacCallum-R2
Silvy Mathew-FA3, Global Health
Kari-Jean McKenzie-R1
Ali-Reza Merali-R1
Jennifer Montis-R2
Mandana Moosavi-R1
Trudy Nasmith-R1
Freda Omaswa-Fellow
Rohit Pai-R3
Michael Payne-R3, Medical Microbiology
Michael Quon-R2
Nikkie Randhawa-R1
Mary Rendell-R1
Manish Sadarangani-Fellow, Peds ID
Jennifer Samilski-R2
Zachary Schwartz-R3
Inna Sekirov-R2, Medical Microbiology
Dave Shaw-R3
Ranjani Somayaji-R2, Calgary
Max Sun-R3
Emilie Stevens-R1
Justine Urness-R3, Global Health, Calgary
Jay Varghese-R2
Shamim Wadiwalla-Fellow, Clinical Immunology
Jessica Wilford-R2, Dermatology
Amanda Wilmer-Resident, Medical Microbiology
Evelyn Wong-R2
Patrick Wong-R2
Alissa Wright-Fellow
MSI Yr 3 placed by UBC Department of Medicine Undergraduate
Medical Education for 1-3 hrs training
Andrei Karpov
Hyein Kim
Bejanmin Jong
Alice Mai
William Munday
Renee Nason
Chima, Navraj
Katherine Shoults
Kateryna Vostretsova
Huei-Hsin Clarice Yang
Undergraduate Scheduled
Name
Program
Start
End
Supervisor
4th Yr Medical
Elective, Sexual
Health Research
Medicine
2012
2012
Shannon
Le, Adrian
Undergraduate UBC Medicine
Program
2011
2012
Lima
Nyguen, David
Clinical Epidemiology Summer
Studentship
(Yr4 medical student)
2012
2012
Lima
Name
Program
Start
End
Supervisor
Chen, Becky
Yr4 Medical Undergraduate
Elective, UBC
2012
2012
Moore
Haley, Laura
Summer Student, UBC
2012
2012
Moore
Heffner, Daniel
Elective, UBC
2012
2012
Moore
Herriot, Ryan
Elective, UBC
2012
2012
Moore
Cosupervisors
Undergraduate Unscheduled
14
Cosupervisors
Le, Dan
Research Elective in Urban
Health (Medicine), UBC
2012
2012
Kerr
Leung, Leslie
Research Elective in Urban
Health (Medicine), UBC
2012
2012
Kerr
Ti
McCloskey, Rosemary Vice President Research
– Undergraduate Student
Research Award, SFU
2012
2012
Poon
Brumme
Mehl, Erika
Elective, UBC
2012
2012
Moore
Murray, Heather
UBC Centre for Blood Research
Scholarship
2012
2012
Poon
Persaud, Steven
Elective, U of Calgary
2012
2012
Moore
Phillips, Mark
Biology, BSc (Summer research
student), U of Victoria
2012
2012
Kerr
Taha, Natalie
Yr 4 Medical Undergraduate
Elective, UBC
2012
2012
Shannon
Verrault, Catherine
Elective, U of Ottawa
2012
2012
Moore
Name
Program
Start
End
Supervisor
Cosupervisors
Anema, Aranka
PhD-Experimental Medicine
2009
2013
Montaner
Hogg, Weiser,
Kerr
Bingham, Brittany
PhD
2010
2014
Shannon
Brumme, Chanson
PhD, UBC- Clinical applications
of ultra-deep sequencing
technologies to HIV-1 treatment
2009
present
Harrigan
Capler, Rielle
PhD-Population and Public
Health
2010
2012
Wood
Chettiar, Jill
MPH
2011
2013
Shannon
Harrigan
Milloy
Graduate Students
15
Crabtree, Alexis
MD/PhD, UBC
2010
2017
Buxton
Cui, Zishan
MSc in Statistics, UBC
2012
2013
Lima
Duff, Putu (Katherine)
PhD
2010
2014
Shannon
Fast, Danya
PhD-Interdisciplinary Studies,
UBC
2009
present
Kerr,
Shoveller
Culhane
Hayashi, Kanna
UBC
2009
2012
Kerr
Csete, Buxton
Heron, Amanda
Physical Education and Health,
MSc, University of Toronto
(Summer research student)
2012
2012
Kerr, Shannon
Himsworth, Chelsea
PhD-School of Population and
Public Health
2011
present
Patrick
Kerr, Tang,
Jardine
Khan, Rabia
MSc-School of Population and
Public Health, UBC
2011
2013
Yassi
Moore,
Buxton
Henry, Wood
Knight, Rod
Interdisciplinary Studies
Graduate Program, PhD
2012
present
J Shoveller
T Kerr
Krusi, Andrea
UBC
2009
2013
Shannon
Rhodes,
Smye
Lee, Guinevere
PhD, UBC- Frontiers of
HIV diversity and evolution:
Selection pressure from novel
drug classes and subtype
2009
present
Harrigan
Luma, Maxo
Public Health, MSc
2012
2012
Shoveller
Kerr
McGovern, Rachel
PhD-Experimental Medicine,
UBC- Characterization of
the HIV-1 genome using
sequencing methods as applied
to viral tropism and early
infection
2010
present
Harrigan
Phillips, Kerr,
Tebbutt
McNeil, Ryan
UBC
2011
present
Kerr
Shannon,
Hanser
Montaner, Michaela
Interdisciplinary Studies
Graduate Program, MSc
2011
present
Wood, Wilkes,
Kerr
Callison
Muldoon, Katherine
PhD
2010
2014
Shannon
Nesbitt, Ariel
MPH
2011
2013
Shannon
Pettes, Tyler
Nutritional Sciences, MSc,
University of Toronto (Summer
research student)
2012
2012
Kerr
Rawat, Angeli
PhD-School of Population and
Public Health, UBC
2010
2012
Yassi
Reddon, Hudson
Physical Education and Health,
MSc, University of Toronto
(Summer research student)
2012
2012
Kerr
Richardson, Lindsey
Sociology, DPhil, University of
Oxford
2008
2012
Gershuny
Kerr
Saberi, Sara
PhD-Pathology and Laboratory
Medicine, UBC
2011
present
Cote
Harrigan
Spencer, Hayley
MSc – Pathology and
Laboratory Medicine
2010
present
Cote
Hull, Walker,
Scott, Owen
O’Kusky
Swenson, Luke
PhD, UBC- The application of
‘deep’ pyrosequencing to HIV
tropism and drug resistance
2009
present
Harrigan
Ti, Lianping
School of Population and Public
2012
Health, PhD
present
Wade, Rachel
PhD-Pathology and Laboratory
Medicine
2010
LOA
Cote
Werb, Daniel
PhD-Epidemiology, UBC
2010
2012
Wood, Buxton
Name
Program
Start
End
Supervisor
Graf, Isabell
PhD student visiting from
Germany. UBC Mathematics
Department
2012
2012
Lima
Moore
T Kerr,
J Buxton
Gorsky, Seow,
Walker, Hull
Graduate Unscheduled
16
Cosupervisors
Graduate Students Supervisory Committees
Name
Program
Start
End
Supervisor
Cosupervisors
Anema, Aranka
Experimental Medicine-PhD
2009
2012
Montaner
Kerr
Brumme,
Chanson
2010
2013
Harrigan
Lima,
Montaner
Caro Vega,
Yanink Neried
Dictamen Subcomité
2010
2013
Madero
Lima
Khan, Rabia
School of Population & Public Health-MSc
2011
present
Yassi
Moore
Knight, Rod
Interdisciplinary Studies Graduate
Program-PhD
2012
present
Shoveller
Kerr
Lee, Laura
Liu Institute for Global Issues,
Interdisciplinary Program-PhD
2009
2013
Baines
Shannon
McNeil, Ryan
Interdisciplinary Studies-PhD
2011
2014
Kerr
Shannon
Rawat, Angeli
School of Population & Public Health-PhD
2009
present
Spiegel
Moore
Saberi, Sara
Pathology & Laboratory Medicine-PhD
2011
present
Cote
Harrigan
Swenson, Luke
2010
2012
Harrigan
Montaner
Académico Ciencias de la Salud
-Posgrado UNAM-PhD
Postgraduate Scheduled
Name
Program
Start
End
Supervisor
SPPH 570/710
Seminar Facilitator
School of Population & Public
Health
2012
2012
Moore
SPPH 523 Lecture
Health
2012
2012
Moore
SPPH 570/710
Seminar Facilitator
Health
2012
2012
Moore
Research Elective in
Urban Health
Medicine
2012
2012
Kerr
Law Civil Liberties
Law
2012
2012
Wood
SPPH 502
Health
2012
2012
Wood
2012
2012
Wood
Doctor, Patient &
Society (DPAS) 420
Cosupervisors
Postgraduate Unscheduled
17
Name
Program
Start
End
Supervisor
Cheung, Peter
Postdoctoral Fellow
2005
present
Harrigan
Cosupervisors
DeBeck, Kora
Postdoctoral Fellow
2010
2014
Wood,
Montaner
Deering, Kathleen
Postdoctoral Fellow
2011
2014
Shannon
Goldenberg, Shira
Postdoctoral Fellow
2011
2014
Shannon,
Silverman
Gonzalez-Serna, Alex
Postdoctoral Fellow
2012
present
Harrigan
Liang, Richard
Postdoctoral Fellow
2012
present
Poon
Lourenco, Lilian
UBC, Masters of Public Health
Practicum
2011
2011
Moore
Lyons, Tara
Postdoctoral Fellow
2012
present
Kerr, Shannon
Marshall, Brandon
Postdoctoral Fellow
2011
2012
Galea
Milloy, MJ
Postdoctoral Fellow
2011
2012
Wood
Richardson, Lindsey
Postdoctoral Fellow
2012
present
Kerr
Small, Will
Postdoctoral Fellow
2010
present
Kerr, Maher
Tapp, Christine
Postdoctoral Fellow; Masters in
Public Health
2010
2012
Calvert
Clinical Teaching (e.g. clinical clerkships, internal medicine, surgery, etc.)
18
Description
Duration
# of trainees
Attending
Physician
Attending Physician, St
Paul’s
Hospital Clinical
Teaching Unit
8 weeks
Approximately 5 trainees
per rotation
Wood
Attending Physician,
St. Paul’s Hospital
Infectious Diseases
Service
7 weeks
Approximately 2-3 trainees per
rotation
Hull
Attending Physician, St. 8 weeks
Paul’s Hospital AIDS
Ward (10C)
Approximately 2-3 trainees per
rotation
Hull
Strathdee
Harrigan
Wood
Patterson
Wood
RESEARCH
HIV-related clinical research is conducted by the AIDS Research Program (ARP) located at the St. Paul’s Hospital Immunodeficiency Clinic (IDC), under the leadership of Drs. Julio
Montaner, Marianne Harris, Silvia Guillemi, and Mark Hull.
During 2012, the ARP actively participated in the following
clinical studies:
•
•
•
•
•
•
•
•
•
•
Switch to Unboosted Atazanavir with Tenofovir study – a
locally initiated randomized controlled trial (RCT) with
industry support pending
A Phase III randomized, double-blind study of the safety
and efficacy of GSK134572 [dolutegravir] 50 mg once daily
to raltegravir 400 mg twice daily (SPRING-2) – a multicentre, international, industry-sponsored RCT of a new
antiretroviral agent
An open-label Phase III study of telaprevir in combination with peginterferon alfa-2a and ribavirin in subjects
coinfected with genotype 1 hepatitis C virus and HIV-1 –
an industry sponsored, multicentre clinical trial of a new
drug for the treatment of hepatitis C in HIV-coinfected
patients
CTN PT011: Penicillin therapeutic drug monitoring in the
treatment of infectious syphilis; do low serum penicillin concentrations correlate with treatment failure? – A
Canadian, investigator-driven, observational study
CTN 222: Canadian HIV/HCV Coinfections cohort – a
Canada-wide, CIHR-funded, prospective observational
cohort, ongoing since 2005.
CTN 236: A study of an HPV VLP vaccine in a cohort of HIV
positive girls and women – a Canada-wide, multicentre,
CIHR-sponsored study
CTN 247: The Canadian cohort of HIV+ slow progressors: a study of host and viral factors associated with
disease progression in long term HIV infected subjects – a
Canada-wide, CIHR-funded observational cohort study,
ongoing since 2005.
Is COPD different in HIV population? and Emphysema and
inflamm-aging in HIV-seropositive patients– two studies in
collaboration with Dr. Paul Man in the UBC Department of
Medicine, funded by the BC Lung Association and CIHR,
respectively
The Liver Cancer in HIV Study Group: A global multi-center retrospective cohort study to investigate hepatocellular carcinoma in HIV-infected patients – a multinational
observational cohort study
Characterizing the scope and correlates of HIV-Associated
Neurocognitive Disorder (HAND) among HIV+ adults attending the St. Paul’s Hospital Immunodeficiency Clinic
(IDC)- a clinical and research database, in collaboration
with Dr. Robin Hsiung in the UBC Division of Neurology
The following are additional current research projects/studies:
Seek & Treat Pilot Project (aka “STOP HIV/AIDS”-Seek and
Treat for Optimal Prevention of HIV/AIDS) is a 4-year (20092013), $48 million project, the first of its kind in Canada, has
expanded access to HIV testing and HIV/AIDS medications
19
among hard to reach populations in BC. This project primarily targeted the Downtown Eastside, and Prince George. The
initiative has been associated with a marked decrease in HIV
new diagnoses (despite steady increases in other STIs and
stable rates of HCV infection), as well as marked decreases
in HIV/AIDS morbidity and mortality. Based on the success to
date, the Ministry of Health has announced long-term funding ($20M per year) to expand the initiative to the rest of the
province starting in April 2013. In addition, we are currently
supporting the implementation and evaluation of TasP in
China, in collaboration with the China CDC and NIDA. Also, in
collaboration with NIDA, we are supporting the implementation of TasP in Puerto Rico. Finally, in collaboration with the
Clinton Health Access Initiative (CHAI) we are supporting the
implementation of TasP in Swaziland. We are also conducting
a related NIDA-sponsored prospective clinical trial of contingency management strategies for testing and engagement in
care (Co-PIs: Hull/Montaner).
Canadian Observational Cohort Collaboration (CANOC) is
Canada’s first integrated network of all registered HIV/AIDS
treatment information from eight cohort databases across the
country. This pan-provincial HIV cohort establishes policy-relevant studies in HIV therapeutics, population and public health.
CANOC is funded by CIHR and the Canadian HIV Trials Network
(CTN). (co-PI: Montaner)
Vancouver Injection Drug Users Study (VIDUS) is UHRI’s longest
running cohort study, running since 1996 and follows HIVnegative participants. Every six months, participants provide
blood samples for testing for HIV and hepatitis and are interviewed about their drug use, access to services, and experiences with the criminal justice system. (PI: Kerr; Co-Is: Wood,
Montaner, Shannon)
ACCESS determines the health needs of HIV-positive injection
drug users and uses the information gathered at interviews
to determine how treatments are affected by various policies
and programs. Participants are referred to HIV services and
care when needed. (PI: Wood; Co-Is: Kerr, Shannon, Montaner,
Harrigan)
At-Risk Youth Study (ARYS – pronounced ‘Arise’) is made up
of 14 – 26 year old ‘at risk’ youth, defined by various factors
including their socio-economic situation, mental or physical
health, drug use, social or physical environment, or family situation. (PI: Wood; co-Is: Kerr, Shannon, Montaner)
Scientific Evaluation of Supervised Injecting (SEOSI) collects
information primarily related to the use of Insite and how
the facility affects drug use practices such as syringe sharing,
public drug use and other factors in participants’ lives that may
compromise their health. (PI: Kerr; co-PI: Wood)
Community-Based Research (CBR) research attempts to
address community priorities through the meaningful involvement of community members throughout the research
process. Research projects emphasizing the participation of
affected communities through partnerships between academics and community-based organizations have been
particularly important in the realm of Canadian HIV/AIDS research. Dr. Kerr began collaborating with the Vancouver Area
Network of Drug Users (VANDU) and the Western Aboriginal
Harm Reduction Society (WAHRS) to undertake a series of CBR
projects. This program involves further capacity-building of
members of VANDU and WAHRS and also seeks to develop an
evidence-based knowledge translation strategy to promote
interventions and policies that will reduce HIV transmission
and promote effective uptake of antiretroviral therapy. (PI:
Kerr, Co-I: Wood)
Sex Work Public Policy Project is funded by CIHR as a national
initiative to develop and engage in evidence-based sex work
policy that promotes health, safety and reduction of harm for
sex workers across Canada (PI: Shannon).
Ethnographic and Qualitative Research is CIHR- and NIH-funded project (across both UHRI and GSHI) and gains information
from in-depth interviews and ethnographic observation of sex
workers and drug users HIV risk environment and experiences
with accessing care: including gendered risk environments of
housing, unsanctioned safer indoor work spaces, transgender
and bisexual women, injection drug users’ opinions of services available at Insite; the effects on injection drug users of
intensified policy activity; and the incarceration experiences of
injection drug users and sex workers. (PIs: Kerr and Shannon,
Co-I: Wood)
Centre for REACH (Research Evidence into Action for Community Health) is CIHR funded. The Centre is a collaborative, national partnership among leading health researchers
in Canada in a wide array disciplines. Its vision is to bring
together critical practice, research, and policy skills as well as
the lived experience of people with HIV to enhance the health
of individuals and communities disproportionately affected
by HIV. Using an interdisciplinary approach and working collaboratively at the intersections of social science, population
health and health services research, the Centre focuses on
three thematic areas: (1)
International working relationships with the Thai AIDS Treatment Action Group (TTAG) has seen UHRI assist in the application to provide training and support for peer driven HIV
prevention, treatment, care and support for injection drug
users in Thailand. (PI: Kerr)
UNDERSTANDING THE PROBLEMS AND FACTORS DRIVING THE
EPIDEMIC reaching beyond individual behaviour to explore
the impact of broader structural and cultural factors as well
as the social determinants of health (i.e., poverty, stigma, discrimination, racism and gender inequality) on risk, resilience,
behaviour and access to health services within communities;
(2) FIND INNOVATIVE AND PRACTICAL SOLUTIONS taking an
integrated approach to prevention and treatment, developing
evidence-based interventions and strategies; and (3) MOVE
RESEARCH EVIDENCE INTO ACTION developing effective KTE
strategies, relationships and networks and having a measurable impact on policy and practice. (co-I: Shannon)
UHRI has also contributed data to the Global Burden of Disease project, specifically calculating the estimates of cocaine
mortality and morbidity rates worldwide.
An Evaluation of Sex Workers’ Health Access (AESHA) is the
GSHI most established cohort, consisting of adult women
(AESHA I, funded by NIH, 2010-2015) and youth (14-24 years,
AESHA II, funded by CIHR, 2009-2014) engaged in street and
off-street sex work across Metro Vancouver. AESHA monitors ongoing trends in public and sexual health interventions
and access to HIV/STI prevention, treatment and care for this
population. (PI: Shannon, co-Is: Wood, Kerr, Montaner).
The Gender, Violence & HIV Team Study is an interdisciplinary
and intersectoral team of researchers and knowledge users
(policy makers, community partners, affected community)
focused on building collaborative and comparative research
on structural violence and structuration of HIV risk, treatment
and care among vulnerable populations of sex workers and
drug users both in Canada and globally. (PI: Shannon, co-PI:
Kerr, co-Is: Wood, Montaner, Deering).
Community Health & HIV Assessment of Men Who Purchase
and Sell Sex (CHAPS) is a community-based, mixed methods
research project with Hustle/HiM and other CBOs (BoysRUs)
in an effort to better understand the sexual health and HIV risk
environment of men in the sex industry, both sex buyers (clients) and male sex workers, including gay, MSM, two-spirited
and heterosexual men. (PI: Shannon, co-I: Kerr).
20
The Gulu Sexual Health Project, funded by CIHR, works with
The AIDS Support Organization (TASO) conducting exploratory
research on the lived experiences of violence, sexual and reproductive health, HIV/STIs and access to care among women
living with HIV, youth and adult sex workers in post-conflict
Gulu District of northern Uganda. (PI: Shannon).
Canada Africa Prevention Trials Network (CAPTN) partners
with the BC-CfE and TASO Uganda research. CAPTN’s mission
is to strengthen independent basic and clinical research capacity in eastern and southern Africa, facilitate and conduct first
class prevention science with high needs populations and link
care, treatment and prevention research. (co-PI: Moore; co-I:
Shannon)
Highly Active Antiretroviral Therapy as Prevention (HAARP)
Study is a 3-year CIHR funded study to examine the value of
HIV treatment in reducing HIV transmission between serodiscordant couples in Jinja, Uganda. HAARP is being implemented in partnership with The AIDS Support Organisation,
Uganda and the Uganda Virus Research Institute/ Medical
Research Council (UK) AIDS Research Program. (co-PIs: Moore,
Montaner; co-Is: Shannon, Hogg, Mills)
ART Program Design and Effects on Clinical Outcomes and HIV
Risk Behaviour: Secondary Analyses from the Home-Based
AIDS Care Project is a 3-year CIHR-funded project to conduct
additional data analysis projects from a randomized clinical
trial which was implemented in Uganda from 2003 – 2009.
The original study was designed as a 3-arm trial to
examine the effectiveness of viral load and CD4 cell count
monitoring in addition to clinical monitoring among individuals receiving ART in a rural setting. The study continued as
a two-arm trial from 2007 until 2009, but has not yet been
analyzed. (PI: Moore)
Long Term Outcomes on ART in Uganda is a five-year pilot
project to examine the effect of the absence of viral load
monitoring on the prevalence of virologically-defined HIV
treatment failure and response to second-line ART among
individuals receiving ART for more than 4 years at the Jinja
service centre of The AIDS Support Organisation in Uganda.
(PI: Moore)
Unrecognized viremia and response to second-line therapy in
Uganda is a one-year pilot project to examine the effect of the
absence of viral load monitoring on the response to secondline ART among individuals receiving ART for more than 3
years at the Jinja service centre of The AIDS Support Organisation in Uganda. (PI: Moore; co-I: Montaner)
The Momentum Health Study is a five-year CIHR and NIH
funded project to examine the effects of further expansion of
ART on HIV risk and sexual- and drug-taking behaviour among
men who have sex with ment in British Columbia. (co-PIs:
Hogg, D. Moore; co-I: Montaner)
Design of HIV V3 Tropism Assay. The study’s primary purpose
is to elucidate a genotypic (sequence) algorithm to identify
the HIV phenotype (CCR5 / CXCR4 / dual tropic) which could
be called a “Tropism Predictor Assay”. Currently there are two
phenotypic assays which could be considered “gold standards”, and one assay which has been used for co-receptor in
the clinical trials of all co-receptor antagonists to date. These
phenotype assays are both relatively sensitive and specific.
The main drawbacks of both these methods are their exclusivity to specific companies, their cost and a long turn around
time. We hope to design a V3 region-based genotypic co-receptor predictor that is as or more sensitive and specific, readily adaptable to sequence based assays, is cheaper and has a
faster TAT than the current phenotypic assay. (PI: Harrigan)
Sequence analysis of human viral and drug affects on HIV/
AIDS. The expanding knowledge of how HIV infects the patient continues to lead to the advent of new treatments. The
BC-CfE has been at the forefront of many of these treatment
regimens. HIV’s ability to mutate rapidly under drug pressure
and develop resistance to antiretroviral drugs has thus far prevented the development of an effective vaccine. Current approaches to the treatment of HIV involve the use of a number
of different classes of antiretrovirals to reduce the patient’s viral load to an undetectable level (<50 copies/mL) and increase
the patient’s ability to fight off opportunistic infections. Under
drug pressure, the virus will mutate and eventually develop
resistance to these antiviral drugs. The battle to discover new
classes of drugs is ongoing, as the virus continues to adapt.
Further, the ability to select treatments depends upon a
laboratory’s ability to provide useful data to physicians about
the amount of virus and the drug resistance of that virus on an
21
individual basis. Recently, the human component of the virus/
human interaction has become an important area of investigation. The ability to fight an infection seems to depend upon
certain genetic factors within the individual. Further research
on these human factors could lead to optimized treatment
regimens and prove useful for vaccine development. (PI: Harrigan)
Review epidemiologic outcomes of DRT testing. Working with
Dr. Sonia Jain of the University of California, San Diego, Dr.
Arthur Poon, Associate Research Scientist, Bioinformatics at
the BC-CfE will develop bioinformatic and statistical methods
for establishing the relationship between antiretroviral drug
failure through the evolution of resistance in HIV and clinical
disease progression. Dr. Poon will perform complete statistical and mathematical analyses on CFAR Network of Integrated
Clinical Systems (CNICS) data. Specifically, he will develop
dynamic Bayesian approaches to longitudinal data on drug
regimen and drug resistance, and work with Dr. Jain in the
development of models of clinical disease progression. (PI:
Harrigan)
Reconstruct within-host evolution of HIV-1 from next-generation sequencing data. Genetic sequencing of HIV populations plays a central role in the treatment of HIV infections
by alerting physicians to the emergence of viruses that are
resistant to specific antiretroviral drugs. Advances in sequencing technologies are making it possible to detect specific variants of HIV at even lower frequencies within a patient, which
can lead to greater optimization of HIV treatment. In addition,
these data enable us to fit models of molecular evolution and
reconstruct the history of an infection from patterns of genetic variation. This project is developing new computational
methods for extracting information from next-generation HIV
sequence data that have significant impacts on HIV treatment
and prevention, specifically to reconstruct the date of HIV
infection, to understand how the host’s immune response
shapes HIV genetic variation, and the genetic characteristics
of transmitted HIV variants that establish new infections. (PI:
Poon)
Drug resistance testing (Clinical Service-ARP/IDC)
Genotypic HIV V3 Tropism Assay-outcome of number 1 above
(Clinical Service-ARP/IDC)
Developed “Recall” software (Clinical Service-ARP/IDC)
Modeling different strategies to reduce the public health
impact of the HCV/HIV epidemic. This is a CIHR- and NIH/
NIDA-funded project for 3 years. The worldwide burden of
hepatitis C (HCV), especially among those individuals who use
illicit injection drugs and those also infected with the human
immunodeficiency virus (HIV), is tremendous. This project proposes to access the long-term impact of increasing HCV treatment coverage as means of preventing individuals from dying
prematurely or from acquiring both HCV and HIV. This idea
originated from the success of using HIV treatment for the
prevention of new infections, which is a concept pioneered by
our group. (PI: Lima)
ADMINISTRATION
Dr. Montaner holds the endowed Chair in AIDS Research at
UBC and is the Director of the BC Centre for Excellence in HIV/
AIDS (BC-CfE), as well as the Director of the AIDS Research
Program and John Ruedy Immunodeficiency Clinic at St. Paul’s
Hospital, Providence Healthcare. He is a former President
of the International AIDS Society (2008-2010), the world’s
leading independent association of HIV professionals. Dr.
Montaner continues to supervise clinical residents and fellows
as well as medical students, through the Infectious Diseases
Residency Training Program at UBC, as well as through the
Preceptorship Program at IDC offered as a 3-month rotation to
family physicians to enhance their skills in HIV/AIDS.
Dr. Harrigan is the Director of the Research Laboratory at
BC-CfE. Under his leadership the lab has established itself not
only as a leading force in Canada, but also as a centre with
considerable international influence. For more than a decade,
Dr. Harrigan has been a local, national, and international leader in the development of cutting-edge translational research
with important implications for the clinical management of
HIV. He has contributed extensively to our understanding of
HIV drug efficacy and resistance, as well as the human and
viral parameters that influence HIV disease progression. Dr.
Harrigan’s research in these areas has played a key role in
enabling the significant improvements in quality and duration
of life afforded patients by Highly Active Antiretroviral Therapy
(HAART). His work primarily focuses on HIV drug efficacy, drug
resistance, and the human and viral parameters that influence
HIV disease progression. At the BC-CfE, his work has involved
investigations using three major cohort studies (VIDUS, VLAS,
and Vanguard), as well as the more than 4,000 patients in the
BC Drug Treatment Program. Research from these cohorts
produced over 22 peer-reviewed papers in 2012. Dr. Harrigan
developed a “next generation” sequencing method to identify HIV-positive individuals who will respond to maraviroc,
the first approved “CCR5 antagonist” drug as well as “ReCall”
software for automated analysis of HIV drug resistance. This
software is provided free of charge. The BC-CfE test and
software has been adopted as the standard test across Canada
and in over 30 countries worldwide.
In addition to providing HIV drug resistance testing as a clinical
service to most of Canada and investigator-driven trials, the
research lab has also received peer-reviewed funding for several studies from the Canadian Institutes of Health Research
(CIHR), Genome Canada, and National Institutes of Health
(NIH).
As well as the Glen-Hillson Professor in Clinical HIV Virology,
Dr. Harrigan also holds the CIHR-GSK Research Chair in HIV/
AIDS and is a Professor in the Division of AIDS, Faculty of
Medicine at UBC.
Drs. Wood and Kerr have been the Principal Investigators at
UHRI since its establishment in 2007, focusing on substance
abuse, infectious diseases, the urban environment and homelessness. There are currently 12 investigators, and over 40
22
staff including knowledge translation coordinators, research
coordinators, ethnographers, nurses, and statisticians. Eighteen students also work for UHRI in a number of disciplines.
There are many dedicated front-line staff that are responsible
for collecting data, including nurses, interviewers, data entry
clerks, transcriptionists and others who are responsible for
gathering the data which is used to identify and understand
the health of urban populations.
Dr. Moore is the Director of the Public Health and Preventive
Medicine Residency Program in the School of Population and
Public Health (SPPH) at UBC. The Program currently has 13
residents spread over 5 years of training. He is also the cocourse coordinator for the resident’s seminar course Introduction to Public Health and Preventive Medicine Practice (SPPH
570/710). He represents the Program on the Senior Executive
Committee of the SPPH, at the Full Faculty Residency Training
Committee and on the Public Health and Preventive Medicine
Specialists Committee of the Royal College of Physicians and
Surgeons of Canada. Dr. Moore also represents Public Health
and Preventive Medicine on the 4th Year Medical Undergraduate Program Committee.
Dr. Shannon has been Director of the Gender and Sexual
Health Initiative since its inception in 2010 (based on a network of studies since 2005), focused on gender and sexual
health research, and HIV/AIDS. There are currently 17 investigators, close to 40 research staff including many dedicated
research coordinators, statisticians, GIS analyst, and front-line
staff (research nurses, interviewers and outreach workers),
as well as 12 graduate students and postdoctoral fellows. She
currently sits on the CIHR HIV Advisory Board (2012-present), and in 2012, sat on review committees for CIHR, NIH and
OHTN. She was also nominated as a member of the Dean’s Advisory Search Committee with the search for an appointment
of Head of the Department of Medicine (2012-present).
Dr. Hull continues clinical and bedside teaching of medical students, residents and fellows through the Infectious Diseases
Residency Training Program at UBC, as well as through the
Preceptorship Program at IDC offered as a 3-month rotation
to family physicians to enhance their skills in HIV/AIDS. He is
also a member of the Scientific Review Committee of the CIHR
Canadian HIV Trials Network.
Dr. Lima is currently the Senior Statistician at the BC-CfE.
She supervises a group of four MSc level statisticians and all
analyses done using data from the Drug Treatment Program at
BC-CfE.
FUTURE DIRECTIONS
HIV Treatment as Prevention (TasP): Based on the success to
date of the Seek & Treat Pilot Project, the Ministry of Health
has announced long-term funding ($20M per year) under our
leadership, to expand the initiative to the rest of the province
starting in April 2013. In addition, we are currently supporting
the implementation and evaluation of Treatment as Prevention (TasP) in China, in collaboration with the China Center for
Disease Control and NIDA. In collaboration with NIDA, we are
supporting the implementation of TasP in Puerto Rico. Also, in
collaboration with the Clinton Health Access Initiative (CHAI)
we are supporting the implementation of TasP in Swaziland.
In April 2013, the Division will host the 3rd International TasP
Workshop in Vancouver. Additionally, we are currently planning the potential expansion of the Seek & Treat approach as
a strategy for disease control/elimination to other therapeutic
areas related to HIV/AIDS. In this regard, we have secured a
$1.5M one-year grant from the BC Ministry of Health to further develop this initiative in collaboration with the BCCDC.
SPECIAL HONOURS AND AWARDS
Montaner:
• Hope is a Vaccine Award, Global Alliance to Immunize
against AIDS
• The Queen Elizabeth II Diamond Jubilee Medal
• Grand Decoration of Honour of Austria
• Honorary Degree, Doctor of Science-honoris causa, Cordoba University, Argentina
Insite continues to play an important role as a larger strategy
to address complex and long-standing problems associated
with addiction, disease, mental illness, homelessness, and
poverty. So far, the evaluation research has shown that Insite:
• is being used by the people it was intended for
• has reduced HIV risk behaviour
• promotes treatment of addiction
• has improved public order
• reduces overdose risk and death
• provides safety for women who inject drugs
• offers medical care for injection-related infections
• does not lead to increased drug use or increased crime
• Vancouver police play an important role in supporting Insite
Wood:
• Tier 1 Canada Research Chair in Medicine
A supervised inhalation facility has been called for after a link
between crack cocaine smoking and HIV infection was found
during a study conducted by UHRI and published in October
2009 in the Canadian Medical Association Journal. The study’s
authors are calling for the evaluation of novel public health
interventions. The report, ‘Drug Situation in Vancouver’,
contains more than 10 years of data on drug use trends, drug
availability, HIV rates and mortality rates among people in
the Vancouver area who use hard drugs such as heroin, crack
cocaine and methamphetamine.
Kerr:
• Scholar Award ($45,000), Michael Smith Foundation for
Health Research, 2006-2012
Dr. Shannon will continue to expand GSHI at BCCfE/UBC,
including research, policy, and interventions, both locally and
internationally.
Shannon:
• MSFHR Career Investigator/Scholar Award, Michael Smith
Foundation for Health Research, 2011-2019
• AccolAIDS Nomination- Science/Health Promotion, Positive Living Society of BC
Dr. Moore is continuing to work with international research
collaborations in Africa and continues to build research capacity with the Division’s primary research partner in Uganda,
TASO.
Dr. Harrigan and his research lab will develop a whole genome
sequencing assay as well as pyrosequencing in clinical applications.
23
Dr. Moore is helping to implement the Momentum Men’s
Health Study, which is examining the effects of ART as prevention among men who have sex with men in BC to inform the
STOP-HIV initiative. He is also developing plans, along with
other members of the Division for a formal epidemiologic
evaluation of STOP-HIV and has submitted a proposal to CIHR
to fund this. He has also submitted a grant proposal to CIHR
to examine the perceptions of physicians in the province
about HIV treatment.
Harrigan:
• CIHR/GSK Research Chair Award in HIV/AIDS at the University of British Columbia ($70,000), Canadian Institutes
for Health Research, 2008-2013
• UBC Faculty of Medicine Distinguished Achievement
Award (Basic Science)
• BC-CfE Meritorious Service Recognition Award
• ACCOLAIDS Science, Research & Technology Award, Positive Living Society of BC
Moore:
• New Investigator Award ($60,000), Canadian Institutes for
• Scholar Award ($80,000), Michael Smith Foundation for
Lima: Career Award ($90,000), Michael Smith Foundation for
Poon:Career Investigator Scholar Award ($90,000), Michael
Smith Foundation for Health Research/St. Paul’s Hospital
Foundation-Providence Health Care Research Institute; 20122020.
Feb 2012:
Dr. Yiming Shao from China Center for Disease Control and other international speakers presented at a
Special Session of the HIV/ARV Update as Vancouver hosted
the AAAS Annual Meeting. Dr. Shannon sits on the WHO/UN
guidelines committee.
Mar 2012:
As part of the celebration of the BC-CfE’s 20th
anniversary, his Excellency Werner Brandstetter, Austrian Ambassador to Canada, presented his country’s Grand Decoration
of Honour to Dr. Montaner for work that made a significant
contribution to combat HIV/AIDS in Austria. At the event, Dr.
Montaner recognized long-serving members of the BC-CFE
staff for their innovation and dedication.
May 2012:
The Division of AIDS and the BC-CfE co-hosted
the 2nd International HIV Treatment as Prevention Workshop
in Vancouver. This 3-day Workshop highlighted the need for
further expansion of the Treatment as Prevention Strategy
worldwide to win the battle against HIV/AIDS. (photo with
Ambassador Eric Goosby, US Global AIDS Coordinator). A
landmark study demonstrates novel indoor safer sex work
space in low-income housing for women promotes HIV and
violence prevention that was submitted as expert evidence to
the Supreme Court of Canada.
Jul/Aug 2012: The XIX International AIDS Conference highlights Treatment as Prevention to end the AIDS epidemic. During his speech at the closing session, former US President Bill
Clinton urges global implementation of the strategy pioneered
by the BC-CfE.
Sep 2012:
BC-CfE, St. Paul’s Hospital and UBC lead new
addiction medicine fellowship program, the first of its kind in
the world, thanks to a $5 million donation spearheaded by Dr.
Wood. (photo with Chuck Jeannes, President & CEO of Goldcorp Inc)
24
Oct 2012:
HIV leaders unveil Declaration to End HIV/AIDS
in America with Treatment as Prevention as a key component
in this historic document that outlines the values and principles that will guide work to end the epidemic. Dr. Wood
named Canada Research Chair in Inner City Medicine at UBC.
Drs. Montaner, Wood and Kerr awarded the Queen Elizabeth II
Diamond Jubilee Medal.
Nov 2012:
Landmark study reinforces benefits of antiretroviral treatment and researchers call for national implementation of the Treatment as Prevention strategy to save lives
and curb the spread of HIV.
Dec 2012:
BC government announces provincial expansion of landmark STOP HIV/AIDS pilot program. Health Minister Margaret MacDiarmid committed annual funding of $19.9
million to health authorities to help fulfill the Province’s vision
for an AIDS-free generation. WHO launches new international
guidelines on HIV prevention, treat and care for sex workers.
ALLERGY & IMMUNOLOGY
Division Members
TEACHING
Professor
Dr. R. Robert Schellenberg
All members of the Division are actively involved
in teaching students, residents, community
physicians and lay persons.
Clinical Professor
Dr. H. C. George Wong
Dr. Donald Stark
Dr. Amin Kanani
Dr. Seung Kim
25
The limited exposure to our subspecialty remains
a problem but the number of students taking
an elective rotation with us has increased
substantially. However, we still have more
students coming from other universities than
our own. This reflects the minimal amount
of allergy and immunology in the curriculum
despite how common these disorders are in any
medical practise. Dr. Schellenberg provides an
introductory lecture on the basic mechanisms
Dr. R. Robert Schellenberg
of allergic inflammation in the Pathology 521
Professor and Head
course. All members actively participate in casebased subspecialty teaching seminars for Med
III / IV students and provide individual officeDIVISION OVERVIEW
based teaching of students who have chosen an
Our division is involved in providing clinical teaching elective rotation in the subspecialty. In addition,
in allergy and immunology at all levels and this has Drs. Stark, Kanani and Schellenberg teach in
the Clinical Skills block for Med I students and
involved new initiatives in patient education and
conduct bedside teaching sessions with Med II
CME programs for physicians.
students.
Following on the original work with representatives
The month-long elective rotation for residents
from the Provincial Blood Services and St. Paul’s
in Internal Medicine and it subspecialties has
Hospital Blood Bank and Outpatient Services,
become increasingly popular in recent years.
we have begun a new program for home selfClinical members commit a half to a full day per
management of PrimaryImmune Deficiency
week of their office practice for each resident
patients by training them to administer antibody
and Dr. Schellenberg has one on one teaching
replacement subcutaneously, thus avoiding the
necessity to come into our Medical Short Stay Unit sessions two half days each week with each
for IVIG treatment. Under the excellent guidance of resident, reviewing basic and clinical topics
our nurse-educator, Adriana Martin, there are now of relevance. The evaluations of this elective
over 80 patients on SCIG in BC, including a growing rotation by residents and students has been very
number living in various parts of the province. Goals good.
are to have a defined clinic where these patients can
have access to specialized services and can be part Major initiatives have been undertaken in
of a national registry. Such a facility would enhance community medical education to physicians,
other health care professionals and to the
patient care while decreasing the requirement for
hospital resources. There remains a critical need for lay public. CME programs organized by Dr.
George Wong through the auspices of the
Ministry of Health support for this program which
would have major benefits for patients and hospital UBC Community Programs are given in various
communities in British Columbia and the
resources throughout BC.
Northwest Territories. These have received
excellent evaluations and are highly appreciated
We are working to expand the number of clinical
by physicians in outlying areas. Each member
teachers, including members in Victoria and
contributes to these programs.
Kelowna. This is progressing and we would hope
to be able to offer electives for students at these
sites so that we could accommodate more requests Dr. George Wong has developed specific
expertise in evaluation of complementary and
from UBC medical students as well as those from
alternative medicine practices and has presented
elsewhere. Dr. Seung Kim and Dr. Ross Chang in
Burnaby have been most helpful teaching residents a number of interesting papers on these aspects
at meetings of the European Allergy, Asthma
and students in their outpatient clinics.
and Clinical Immunology as well as the World
Allergy Organization International Scientific Conference this year.
Dr. Stark is involved with a national study sponsored by the
He is a member of the BCMA committee on allied health and
AllerGen NCE evaluating “Anaphylaxis and Treatment Methods
alternative therapies.
within the School System.”
Dr. Amin Kanani is a member of the Jeffrey Modell Foundation
of Canada, an organization that promotes awareness of primary Dr. Schellenberg is a member of the steering committee of
the National Lung Health Framework. This organization is
immune deficiency with health care providers and the lay
now awarding grants aimed at improving awareness and
public. He has organized a local Immunology Journal Club that
management of lung disorders.
brings together pediatric and adult immunologists to foster
interaction and share knowledge and the development of
Dr. Wong is conducting studies assessing the use and potential
needed laboratory testing. He and Dr. Schellenberg have been
harmful effects of herbal and Chinese medicines and regularly
involved in an initiative that led to adding the “Ten Warning
Signs for Primary Immune Deficiency” to the pamphlet “Do Bugs presents at local and international meetings.
Need Drugs”, a highly successful program in BC and Alberta that
reviews signs of infections and general considerations for health
care providers (25,000 pamphlets distributed). This collaboration CLINICAL SERVICES
has been very fruitful and further aspects of joint teaching
sessions are being discussed.
All members are actively involved in providing clinical
consultative services in Allergy and Immunology to the
All members have been actively involved in providing teaching
community. Dr. Mandl continues to provide allergy clinics to
seminars in various communities in British Columbia. Dr. Kanani a number of aboriginal communities in Northern BC. Dr. Stark
has been involved with the St. Paul’s Internal Medicine Update provides outreach clinics in Prince George and Sechelt. He
Course and members of our division are asked regularly to speak has been active in initiating subcutaneous immunoglobulin
at the highly popular St. Paul’s General Practitioner Course.
treatment for patients in northern BC communities. Dr. Kanani
serves needs in Surrey with a clinic one day each week. Dr. Wong
has had a specific interest in complimentary medicine practices
and the potential harmful effects of specific treatments.
RESEARCH AND CLINICAL PRACTICE GUIDELINES
The members at St. Paul’s hospital have a major interest in
management of Primary Immune Deficiency and have initiated a
number of research projects as well as interactions with the lay
organizations, Canadian Immune Deficiency Patient Organization
and the Jeffrey Modell Foundation. Drs. Schellenberg, Kanani
and Stark are undertaking a study evaluating the quality of
life and health outcome parameters of patients with primary
immunodeficiency, comparing IVIG treatment to SCIG treatment.
An earlier study evaluating quality of life parameters in patients
receiving IVIG demonstrated significant correlation of IgG serum
levels to indices of fatigue
Dr. Kanani was a committee member evaluating subcutaneous
vs. IV immunoglobulin therapy for Primary Immune Deficiency,
evaluating the efficacy and cost effectiveness for the Canadian
Agency for Drugs and Technologies in Health (CADTH). This
report has been helpful in defining cost savings with home
therapy.
A major initiative at St. Paul’s Hospital to improve the care of
patients with primary immunodeficiency is being led by Drs.
Schellenberg, Stark and Kanani in conjunction with Anita Skihar
(Supervisor of Outpatient Services), Daryl Gouthro (Manager
of the Blood Bank) and members of the Provincial Blood
Coordinating Office. This has led to an excellent document
dealing with guidelines, protocols, patient and nursing
information on home subcutaneous immunoglobulin therapy
which has been adopted by other provinces ( available on the
PBCO website). The goal of this project is to have a provincial
centre and resource for all patients with primary immune
deficiency and link registries with others across Canada and
globally.
NATIONAL AND INTERNATIONAL INITIATIVES
Members are very involved with the national programs for
Dr. Schellenberg was a member of a Canadian Blood Services
Allergy and Clinical Immunology.
committee formulating evidence-based guidelines for the use of
IVIG and scIG in patients with Primary Immune Deficiency. These Dr. Schellenberg is the Chair of the Examination Committee
have been recently published.
for Clinical Immunology subspecialty of the Royal College of
Physicians and Surgeons of Canada. He is also a Past-President of
Dr. Schellenberg was also involved in the formation of guidelines the Canadian Society of Allergy and Clinical Immunology.
for the management of allergic rhinitis and is a member of a
multidisciplinary group that has recently published practice
Dr. Stark has been the Chair of the national Subspecialty
guidelines for rhinosinusitis.
Committee for Clinical Immunology and Allergy until stepping
down this year to work on the development of our training
Drs. Stark, Kanani and Schellenberg were members of a
program at UBC. He is also a Past-President of the Canadian
committee that recently published updated guidelines for
Society of Allergy and Clinical Immunology.
management of hereditary angioedema.
26
Dr. Kanani is a member of the Steering Committee of the Jeffrey
Modell Canadian Immunodeficiency Network and a member
of the Royal College of Physicians and Surgeons Examination
Committee for Clinical Immunology.
Dr. Schellenberg is a member of the Medical Advisory
Committee of the Canadian Immune Deficiency Patient
Organization. He is also a member of the National Lung Health
Framework Steering Committee and the Canadian Hereditary
Angioedema Network.
Dr. Stark is a member of the Board of Directors for the Canadian
Foundation for Allergy and Clinical Immunology, a charitable
organization of which Dr. Stark was the founder.
Dr. Wong is a member of the Adverse Reaction to Drugs and
Biologics Committee of the American Academy of Allergy,
Asthma and Immunology.
All members are actively involved in local, national and
international committees dealing with their areas of interest. Dr.
Stark remains the Economics Chair from the section of Allergy
and Clinical Immunology for the Society of Specialist Physicians
and Surgeons of BC. Dr. Wong is a member of the BCMA Allied
Health and Alternative Therapies Committee.
FUTURE DIRECTIONS
A major initiative of the division is the development of a
Comprehensive Care Program for patients with Primary
Immune Deficiency in British Columbia. In conjunction with the
Provincial Blood Coordinating Office, an in-depth document
has been developed for the home therapy with subcutaneous
immunoglobulin. This is being used for training both nursing
educators as well as patients and our program is already being
highlighted across the country. We plan to continue to expand
our home SCIG program so that all patients in BC with primary
immune deficiency will have the option of home treatment.
We are working collaboratively with groups across the country
to establish a registry of these patients for improved care and
opportunities for multi-centred research initiatives. Locally
we are working to have a specific out-patient clinic where
management can be better coordinated, especially as we move
to home immunoglobulin replacement therapy. We are the first
adult centre to initiate this and are developing a business plan
to the Ministry of Health to make this a provincial resource that
would provide superior, standardized care at lower cost.
27
CARDIOLOGY
Division Members
Professor
Dr. John Cairns
Dr. Charles Kerr
Dr. Andrew Krahn
Dr. G. B. John Mancini
Dr. John Mayo
Dr. Simon Rabkin
Dr. Teresa Tsang
Clinical Professor
Dr. Ronald Carere
Dr. Anthony Fung
Dr. Kenneth G. Gin
Dr. Jaap Hamburger
Dr. Victor Huckell
Dr. Andrew Ignaszewski
Dr. Marla Kiess
Dr. Ian Penn
Dr. Donald Ricci
Dr. John Yeung-Lai-Wah
Dr. John Webb
Associate Professor
Dr. Hartmut Henning
Dr. Karin Humphries
Dr. Eve Aymong
Dr. Sammy Chan
Dr. Brett Heilbron
Dr. John Jue
Dr. James Nasmith
Dr. Alan Rabinowitz
Dr. Jacqueline Saw
Dr. Christopher Thompson
Dr. Graham Wong
Assistant Professor
Dr. Krishnan Ramanathan
Dr. Jason Andrade
Dr. Matthew Bennett
Dr. Robert Boone
Dr. Santabhanu Chakrabarti
Dr. Marc Deyell
Dr. Jasmine Grewal
Dr. Saul Isserow
Dr. Pui-Kee Lee
Dr. John LeMaitre
Dr. Robert Moss
Dr. Parvathy Nair
Dr. Tara Sedlak
Dr. Lynn Straatman
Dr. Carolyn Taylor
Dr. Mustafa Toma
Dr. Stanley Tung
Dr. Sean Virani
Dr. David Wood
Clinical Instructor
Dr. Bradley Munt
Associate Member
Dr. Amin Aminbakhsh
Dr. Tom Ashton
Dr. Kapil Bhagirath
Dr. Margaret Blackwell
Dr. Albert Chan
Dr. Eric Fretz
Dr. Arthur Friesen
Dr. Lyall Higginson
Dr. Peter Klinke
Dr. Akbar Lalani
Dr. Jonathon Leipsic
Dr. Paul Novak
Dr. Randall Sochowski
Dr. Gerald Simkus
Dr. Laurence Sterns
Dr. Elizabeth Swiggum
Dr. Anthony Tang
* Joint tenure appointment 50:50 with Department of Radiology
28
Andrew D. Krahn, MD, FRCPC, FHRS
Professor of Medicine & Head,
UBC Division of Cardiology
The Sauder Family and Heart & Stroke
Foundation of BC & Yukon
Chair in Cardiology,
Paul Brunes UBC Professorship in Heart
Rhythm Disorders
for ongoing strengthening of the goals of the
Division within the Department of Medicine.
Acting Co-Chiefs Drs. Andy Ignaszewski and Ken
Gin will evolve into a role of site chiefs with an
operational focus, with a strong collaborative
relationship with Dr. Krahn as the UBC
academic Division Chief. Their goals are linked
to some of the conditions around Dr. Krahn’s
recruitment, including the process of creation
of an academic practice plan, the formation of
a Provincial Cardiovascular Outcomes Centre,
and the recruitment of individuals to enhance
the academic and clinical goals of the Division
at large. There is great energy and excitement
around this evolution in the Division, and an
improvement in relationships between Division
Members and institutions. This positive energy
is being used to focus on constructive initiatives
as outlined below that speak to the commitment
of the Division towards its academic growth.
The Division expanded during 2012, and
welcomed 3 other new clinical faculty –
Dr. Jason Andrade, an electrophysiologist
specializing in cryoablation; Dr. Marc Deyell, an
electrophysiologist specializing in ventricular
tachycardia and Dr. Tara Sedlak, specializing in
women’s heart health. At the end of 2012 the
Division comprised 48 active faculty members (9
full-time and 39 clinical faculty). Ten additional
Administrative Overview
members enjoy emeritus, honorary or adjunct
The Division of Cardiology has seen an extraordinary status. We also welcomed a new Associate
year in this time of change in 2012. A long awaited Member, Dr. Kapil Bhagirath, based at Surrey
Memorial, who brings our Associate membership
goal has been achieved, through the arrival of
to 20. Congratulations to Dr. Eve Aymong who
Dr. Andrew Krahn as the UBC Chief of Cardiology.
was promoted to Clinical Associate Professor in
This marks the result of several years of planning,
2012.
including the creation of Chairs:
• Paul Brunes UBC Professorship in Heart Rhythm
Education
Disorders awarded to Dr. Andrew Krahn
• McLeod Family Professor in Valvular Heart
Disease Intervention at St. Paul’s awarded to Dr. The UBC Division of Cardiology has enjoyed
a long-standing strength in cardiovascular
John Webb
education, with a nationally recognized residency
• Pfizer/Heart and Stroke Foundation Chair in
Cardiovascular Prevention Research awarded to training program. This strong program continues
to flourish under the direction of Dr. Parvathy
Dr. Scott Lear
• UBC Heart and Stroke Foundation Professorship Nair, with accreditation anticipated in fall of
in Women’s Cardiovascular Health awarded to 2013. The Program is poised to endure this
tribulation and emerge in a highly successful
Dr. Karin Humphries
• UBC Charles Kerr Professorship in Heart Rhythm fashion, with broad constituent support by the
Postgraduate Education Committee.
Management - not yet appointed
The commitment to developing an increased
As part of the resurgence of focus on the
emphasis on the academic mission, and a
academic mission, the Division has formulated
recognition that external leadership will provide
an Education Committee, initiated by Dr. Andrew
new energy into the further development of the
Krahn. This Education Committee will be
Division. This occurs in the context of several
directed by Dr. Victor Huckell, with the goal of
new recruits to the Division, targeting clinical and
academic needs of the Division and an opportunity creating a structure and subsequently function
to enhance the educational mission. High hopes are in place
for the cultivation of education scholarships, combined with the
creation of a Chair in Cardiovascular Education. Ten Members
of the Division have been identified to fulfill various roles in
undergraduate, postgraduate and continuing medical education.
These roles have been accompanied by development of roles
and responsibilities, that will be enabled by the emerging
academic practice plan for the Division.
Research
The Division is undergoing a renaissance with an emphasis
on creating infrastructure and placing a priority on research
capacity building. This includes the formation of a practice
plan, intended to identify the resources for both salary and
operating funds to protect the time of clinicians, and enable the
infrastructure to enhance research productivity. Peer reviewed
research funding is an important target for the Division, and
an emerging priority in the cultivation of research capacity. In
conjunction with this, the Division is pleased to announce the
emergence of the BC Centre for Improved Cardiovascular Health
(BC ICV Health), which will be located at St. Paul’s Hospital. The
BC ICV Health has 5-year funding to prioritize capacity building
and research, with a focus on knowledge generation, outcomes
research and knowledge translation with a provincial lens. The
Outcomes Centre will emphasize enabling clinician investigators
and research teams. These teams and proposals will take
advantage of the BC Cardiac Registry, targeting access to data
that will link Registry data with vital statistics, Pharmanet and
related outcome metrics.
Clinical Activities
The Division has its primary clinical and academic activities
at Vancouver General Hospital (VGH) and St. Paul’s Hospitals,
with a goal to create a broader Provincial perspective in
partnership with leading sites in all health regions. The VGH
and St. Paul’s sites have continued to strengthen relationships
with regional models of care gaining traction, particularly in the
area of Cardiac Rehabilitation, Catheter based intervention and
Electrophysiology. Previous plans to expand expert services in
transcatheter valve therapeutics and electrophysiology to the
VGH site have been resounding successes, under the direction of
Drs. David Wood and Matthew Bennett.
Regional specialty clinics including Heart Failure and Atrial
Fibrillation have steadily grown. They have welcomed the
Inherited Arrhythmia Clinic at St. Paul’s Hospital, the larger of
the 2 sites in the new BC Inherited Arrhythmia Program that
partners with Pediatrics and Medical Genetics. A focus on
Women’s health and cardiovascular disease has emerged with
the recruitment of Dr. Tara Sedlak, who has opened a Women’s
Heart disease clinic at VGH. She is part of a team with a focus
on this area including Women’s Heart Disease Chair Dr. Karin
Humphries, pregnancy and heart disease expert Dr. Marla Kiess
and women’s coronary disease lead Dr. Jackie Saw. St. Paul’s
Cardiology has championed RACE (Rapid Access to Cardiology
Expertise). This is a telephone support service, which provides
rapid access to an on call cardiologist to provide advice. The
service has met incredible success and now has been rolled
out across multiple subspecialties. It has received widespread
critical acclaim and has received multiple national awards.
In parallel with the emergence of these new ambulatory
initiatives, the Heart Centre at St. Paul’s is actively engaged
in the complex planning process for the new ambulatory
The flagship research program of the Division is the structural
tower under its new director Andy Ignaszewskki. Under the
heart program. This program has announced the formation
direction of Dr. John Webb and lead clinically by Dr. Robert
of the Vancouver Centre for Heart Valve Innovation based at
Boone, the Vancouver Centre for Heart Valve Innovation has
St Paul’s Hospital, led by Dr. John Webb. This group has global
established a new program for catheter based therapy for mitral
recognition as a field leader in the realm of structural heart
regurgitation (MitraClip), and the group anticipates further first
disease, with a broad range of engaged constituents from
in human trials of novel devices within the next 12 months.
cardiovascular imaging, biomarkers, technical innovation and
The Providence Health cardiac site at Mount Saint Joseph
outcome science with over 200 publications in the field. Dr.
Jonathan Leipsic leads an incredible coalition of cardiovascular Hospital continues to grow and receive positive reviews with
imaging investigators, including Dr. John Mancini in providing CT the recruitment of Dr. Jonathan Tang. With on-site inpatient
Core lab analyses for major clinical trials, with 43 manuscripts in and outpatient specialist cardiology consultation services,
echocardiography, and an expanded ECG laboratory, there has
2012!
been demonstrated improvement in patient outcomes and
decreased lengths of stay. Dr. Tang is cultivating an outstanding
Dr. Karin Humphries continues to work on her area of focus,
community education experience that has been very well
women and cardiovascular disease, with the awarding of a
CIHR grant to explore sex differences in cardiac troponin levels received by several postgraduate residency programs. It is
among patients presenting to the ED with chest pain as the chief anticipated that with future growth the Division can continue
to provide and diversify cardiac care to the East Vancouver
compliant. In her role as Scientific Director of the BC Centre
for Improved Cardiovascular Health (ICV Health), she is working and Mount Saint Joseph community. Inter site collaboration
continues to grow with the successful launch of a regional STEMI
with the Executive Committee to identify the first provincial
protocol by Drs. Graham Wong and Krish Ramanathan.
projects that ICV Health with engage in. The Division envisions
taking its recent commitment to research with an Academic
VGH started its transcatheter valve program as part of an
Practice Plan to cultivate the emergence of several other
realms of strength into a position of national and international Integrated UBC program. David Wood has championed the
3M approach (Multidisciplinary Multi modality Minimalist
prominence.
29
approach), which allows next day discharge. The interventional
group also continues research on the accuracy of coronary flow
measurements in acute coronary patients and is embarking
on a partnership with McMaster University to develop a multicentre study in this realm. Dr. Jackie Saw has done important
work in demonstrating that up to 25% of myocardial infarctions
in women under age 50 years are due to spontaneous coronary
dissection. She is working towards implementation of a
Canadian registry. VGH has cultivated a heart rhythm service
(electrophysiology), and Dr. Jason Andrade performed the
first AF cryoablation in western Canada, and has successfully
obtained a Heart and Stroke Foundation operating grant. VGH
has established linkages with Children’s hospital as well as the
Cancer Control Agency of BC in launching a Cardiology Oncology
program, with peer reviewed clinical trial funding obtained by
Dr. Sean Virani. The VGH Division is the first specialty group
to partner with the Divisions of Family Practice to develop a
shared care model to improve patient care. The UBC Division of
cardiology continues to have strong and fruitful collaborations
with radiology, and this has strengthened the clinical, residency
training, and research aspects of the Cardiology program. The
UBC Division of Cardiology has committed substantial funds to
assist cardiology residents and fellows in achieving academic
careers.
Conclusion
The UBC Division of Cardiology has seen a renewed energy
in focusing on the academic mission in the context of a busy
clinical delivery system. Teaching and research enhancement is
expected as the Academic Practice plan completes its planning
and launch phases in the 2013-14 year.
30
CRITICAL CARE MEDICINE
Division Members
Professor
Dr. Peter Dodek
Dr. James Russell
Dr. Keith Walley
Clinical Professor
Dr. Juan Ronco
Dr. John Tsang
Associate Professor
Dr. Najib Ayas
Dr. Delbert Dorscheid
Dr. Dean Chittock
Dr. Vinay Dhingra
Dr. William Henderson
Dr. Cheryl Holmes
Dr. Sean Keenan
Assistant Professor
Dr. John Boyd
Dr. Adam Peets
Dr. Gregory Grant
Dr. Susan Kwan
Dr. Ruth MacRedmond
Dr. Grant McCormack
Dr. Scot Mountain
Dr. Steven Reynolds
Dr. Katherine Craig
Dr. Craig Fava
Dr. Edgar Lau
Dr. Carole-Anne Yelle
Associate Members
Dr. Ken Cunningham
Dr. Tharwat Fera
Dr. Gordon Finlayson
Dr. Ryan Foster
Dr. Donald Griesdale
Dr. Morad Hameed
Dr. George Isac
Dr. Edward Lawson
Dr. Greg Martinka
Dr. Demetrios Sirounis
Dr. David Sweet
Dr. Andrew Webb
Dr. Sheila Webster
31
presentations in 2012 including at the Societe
de Reanimation de Langue Francais (SRLF), in
Paris, France, the 42nd Critical Care Congress,
Society of Critical Care Medicine in Houston,
Texas, Temple University School of Medicine
in Philadelphia, Pennsylvania, the Department
of Anesthesia, Stanford University, in Palo
Alto, California, and for the Society of Surgical
infections, in Chiba, Japan and at the Chiba
University Graduate School of Medicine, Chiba
University in Chiba, Japan. Dr. Peter Dodek was
an invited speaker for the B.C. Patient Safety and
Quality Council, for the Society for Critical Care
Medicine podcast, and was a Visiting Professor at
the University of Toronto, Division of Critical Care
Medicine, in Toronto, Ontario. Dr. Adam Peets
gave a Frank S. Rutledge Lecture at the Canadian
Dr. Najib Ayas
Critical Care Forum in Toronto, Ontario. Dr.
Associate Professor and Head
Vinay Dhingra chaired a session at the Canadian
Critical Care Conference (CCCC) and also was
on the organizing Committee of the CCCC and
gave an ultrasound workshop in Critical Care.
Dr. Najib Ayas gave a presentation at Heart and
The UBC Division of Critical Care Medicine is multi- Lung FEST in Vancouver and at the Canadian
Chief Residents Conference in Vancouver. Dr.
disciplinary in nature with 25 full time faculty
members and 13 associate members. Our members David Sweet was an invited speaker at the NY
are qualified critical care specialists with Medicine, State Sepsis Forum Meeting, BC Sepsis Network
Surgery, and Anaesthesia and Emergency Medicine Day, at the Provincial Grand Rounds Emergency
backgrounds. They participate in patient care at St. Medicine, Vancouver Island Emergency Grand
Paul’s Hospital, Mount Saint Joseph’s Hospital, Royal Rounds, BCPSQC Quality Forum, and the Rural
Physician Network. Dr. Steven Reynolds gave
Columbian Hospital, Richmond General Hospital,
six presentations in 2012 including one at the
Kelowna General Hospital, Vancouver General
Hospital, Lions Gate Hospital, and Surrey Memorial Canadian Critical Care Forum. He also was
the moderator at a session at the Whistler
Hospital.
Anesthesiology Summit and the moderator/
organizer at a session infections in the ICU at the
The Critical Care Medicine Members continue
CCCC. Dr. Reynolds was also interviewed on the
to make contributions in education, knowledge,
Society of Critical Medicine Podcast program.
research, and clinical care. Our goal is to improve
our clinical care, increase research output,
Division members were recognized for their
and improve our educational efforts (including
achievements and contributions. Congratulations
undergraduate, post-graduate, and CME).
everyone for the following Awards received:
Clinical, research, educational, and administrative
collaborations among the hospital sites have
increased over the past few years and are expected • Martin M Hoffman Award for Excellence in
Research, UBC Department of Medicine (Dr.
to continue. We will continue to examine and adopt
Peter Dodek)
innovative clinical approaches and technologies
•
Faculty Research Award, UBC Department of
to improve the care of critically ill patients (e.g.,
Medicine (Dr. Peter Dodek)
echocardiography, ultrasound, computer support/
•
UBC 4YF Fellowship Award (Dr. William
monitoring, checklists, novel methods of cardiac/
Henderson)
pulmonary support). We will explore ways to obtain
•
AFMC Young Educators Award, Association
and support excellent clinical and basic science
of Faculties of Medicine of Canada (Dr. Adam
researchers to expand our research capacity and
Peets)
collaborations.
• Frank S. Rutledge Award of Excellence in
Critical Care Teaching (Dr. Adam Peets)
Division members gave numerous presentations
•
Award for Outstanding Mentorship, UBC
as invited speakers and were involved with many
Division of Critical Care Medicine (Dr. Adam
local, national and international conferences
Peets)
and meetings. Dr. James Russell gave eleven
•
•
UBC Department of Anesthesiology, Pharmacology
& Therapeutics Dmitri Giannoulis Memorial Resident
Appreciation Award (Dr. Donald Griesdale)
People First Nomination, Vancouver Coastal Health (Dr.
Donald Griesdale)
Education
The University of British Columbia Adult Critical Care Medicine
Training Program continued under the direction of Dr. Gordon
Finlayson who was appointed Director in 2012. He took
over from Dr. Adam Peets, who was appointed Associate
Head, Education, for the Department of Medicine, UBC.
Congratulations to Drs. Finlayson and Peets for your new
appointments.
The two-year Critical Care Medicine subspecialty-training
program accepts up to 4 new trainees per year and is fully
accredited by the Royal College of Physicians and Surgeons
of Canada. It is structured to provide trainees with both an
outstanding clinical and research environment in which to learn.
Three new fellows were matched to the program in 2012 and
will begin their fellowships in July 2013.
During their Fellowship, trainees primarily rotate through three
tertiary care hospitals (St. Paul’s Hospital, Vancouver General
Hospital, and Royal Columbian Hospital), and are exposed to
a broad range of patients with critical illnesses. This includes
exposure to: patients with HIV, patients who are post-organ
transplantation, patients with multiple traumas (including
head injury), patients requiring extracorporeal membrane
oxygenation (ECMO), and post-cardiac surgery patients.
Dr. Adam Peets continued to serve on the Written and Oral
Examination Committee for General Internal Medicine for the
Royal College of Physicians and Surgeons of Canada (RCPSC).
Dr. Steven Reynolds was named to the RCPSC executive
committee for Critical Care Fellowship Education. He has
taken on the role as a co-supervisor of a master student in
neurokinesiology at Simon Fraser University.
Division members continued to mentor and teach students at
the undergraduate, graduate, and postgraduate levels and with
bedside teaching.
Research
The Research Program in Critical Care Medicine is
comprehensive, spanning from genetic and molecular biology
studies, to education, clinical trials, and quality improvement.
The basic science research program is based primarily in the UBC
James Hogg iCAPTURE Centre for Cardiovascular and Pulmonary
Research at St. Paul’s Hospital. The critical care medicine clinical
research program is focused primarily in the intensive care units
of St. Paul’s Hospital, Royal Columbian Hospital, and Vancouver
General Hospital. Active research is ongoing in the fields of
sepsis genetics, biomarkers of infection, inflammatory markers
and cytokines, ARDS, pathophysiology of pulmonary embolism,
alternative ventilation technologies, immune signaling and
sepsis induced cardiac dysfunction. The areas of ongoing active
clinical and education research include assessment of simulation
in teaching, epidemiology and outcomes in traumatic illness
(including TBI), impact of resident fatigue, patient safety, and
quality improvement.
Congratulations to Dr. Keith Walley who was appointed Director
of the UBC James Hogg Research Centre in 2012. Dr. Walley’s
areas of research interest are pathophysiology of cardiovascular
dysfunction in critical illness, oxygen transport in peripheral
tissues, and genetic determinants of outcome from critical
illness. Dr. Walley continues to work with Dr. John Boyd to
Drs. Adam Peets and Najib Ayas continue to supervise the
investigate basic mechanisms underlying impaired myocardial
resident training at St. Paul’s Hospital and Dr. Robert Sharpe
took over as the lead supervising the resident training at Royal function and other organ dysfunction during inflammatory
disease states, including sepsis. Research has continued
Columbian Hospital. Dr. Kathy Craig has taken on the fellow
in the area of Genomics of Critical Care. Studies of SNP’s
training portfolio at RCH. Dr. David Sweet is the ICU Student/
and haplotypes of key inflammatory and innate immunity
Resident Education Director at Vancouver General Hospital
genes are conducted in (1) critically ill ICU patients who have
(since 2008) and Dr. Ryan Foster is the Residency Director of
critical care (Family Practice Rural Residents) at Kelowna General SIRS, sepsis, and septic shock and (2) cardiovascular surgery
patients. In 2012, Dr. Walley had funding from four grants,
Hospital. Dr. Cheryl Holmes is the Site Director for the new
has had 7 refereed journal publications, and 7 Lectures at
Southern Medical Program at Kelowna.
National/International Meetings. Dr. Walley served in 2012
on the Centre for Drug Research and Development Scientific
Dr. Griesdale is the Research Director for the UBC Critical Care
Review Committee, the James Hogg Research Centre Executive
Residency Training Committee responsible for mentoring
Committee, and the Faculty Executive Committee.
UBC Critical Care Medicine Fellows for ongoing research
development and education.
Dr. John Boyd was the recipient of a VCH/PHC Technology
Innovation Fund (‘Implementation of an acute hemodynamic
Dr. Vinay Dhingra is the Medical Director of Fundamentals in
Critical Care Support (FCCS) teaching over 100 residents annually assessment service through the use of the revolutionary VScan
for over 10 years. This year Dr. Dhingra was the Medical Director hand-held ultrasound’) in 2012. He continues work on a CIHR
for the inaugural FCCS in community held in Vernon BC, teaching Catalyst grant ($600,000) and a National Sanitarium Association
(NSA) grant (333,332 per year until 2016) received in 2011, as
critical care first responders in the community.
well as with salary support from MSFHR for his project, ‘Innate
The ICU residency training program includes residents from
Medicine, Anaesthesia, Surgery, Emergency Medicine, Family
Practice, and Neurology. It is a comprehensive program with
weekly simulator sessions and video-on-demand lectures.
32
immunity and its influence on cardiovascular function,’ Dr. Boyd over 149 submissions and attended 34 meetings as a Primary
Reviewer for Full Board meetings. Dr. Tsang is interested in
had 5 publications in 2012.
ethical principles and concepts, and has become aware of the
many regulations in the area through diligent work. Dr. Tsang
Dr. Dodek is co-investigator on several grants received in 2012
including; from CIHR on Clinical Practice Guidelines for Ventilator had 1 peer reviewed publication in 2012.
Associated Pneumonia (PI J Muscedere; $99,079), CIHR
Dr. Najib Ayas is co-investigator on a CIHR planning grant
Knowledge Translation Network (PI J Muscedere; $599,611),
received in 2012 (PI Julie Carrier) and continues work on a CIHR
also from CIHR (‘A Systematic and Methodological Review of
Neuromuscular Electrical Stimulation in the Intensive Care Unit,’ Team Grant (Team Grant Sleep Disordered Breathing) received in
2010. He had 6 publications in 2012. Dr. Ayas in 2012 served on
PI D. Cook), from PSI and the Academic Medical Organization
of Southwestern Ontario, PI K. Koo), and from NCE (‘TechValue the Grant Review Committee, Operating Grants, Canadian Lung
Association, Grant Review Committee, New Investigator Awards,
Net’, PI D. Heyland, $23,888,157 until 2017). He had 10 peer
Grant Review Committee, Scholar Awards, MSFHR, and Grant
reviewed publications in 2012. Dr. Dodek also served in
Review Committee, Innovation Grant, VCH.
2012 as co-chair of the Canadian Critical Care Trials Group,
Grants and manuscripts review committee, a member of the
Canadian Critical Care Knowledge Translation Network Steering Dr. Demetrios Sirounis is the recipient of two Providence
Committee, a member of Tech Value Net (Technology Evaluation Health Care Technology Innovation Fund awards for ECMO in
the ICU and for the introduction of a new esophageal Doppler
in the Elderly—a National Centers of Excellence network), a
member of the Research Management Committee and as Grants technology for hemodynamic monitoring in acute care setting.
He participates in numerous research initiated at St. Paul’s
Officer, and a member of CARENET (Canadian Association of
Hospital.
Researchers at the End of Life Network).
Ongoing interests for Dr. Dhingra include the establishment of
Dr. D. Griesdale is co-investigator on a NIH grant received in
echocardiography and ultrasound in the ICU. He had 2 peer
2012 (EPVEnt-2-A Phase II Trial Esophageal, Pressure Guided
Ventilation, PI Dr. Stephen Loring & Dr. Daniel Talmor, $950,000). reviewed publications.
Dr. Griesdale had 8 publications and 1 book chapter in 2012.
Dr. William Henderson had 7 peer-reviewed publications.
Dr. James Russell is co-Investigator on a CIHR catalyst grant
Dr. Steven Reynolds received funding as the Principal Applicant
(‘SONRIS. Sepsis Outcomes National Registry to Improve
Survival, PI Dr. John Boyd, $600,000). He had 13 peer reviewed on the CIHR POP Phase 1 Trial of a novel transvenous phrenic
nerve pacer for diaphragm activation in mechanically
publications in 2012 and 1 book chapter. Dr. Russell was also
ventilated critically ill patients (PI S. Reynolds, $160,000). He is
selected and appointed as the Chief Medical Officer of the
conducting a pilot study on antibiotic stopping algorithms and
British Columbia Clinical Research Infrastructure Network
procalcintonin in the ICU supported by the Fraser Health Scholar
(BCCRIN). BCCRIN aims to increase the quality, quantity and
funding of clinical research in BC. Dr. Russell in 2012 served as a award (PI S Reynolds, $50,000). He is a co-applicant on the
member of the Executive Committee, BC Personalized Medicine successful CIHR Knowledge Translation Network (PI J Muscedere
Initiative (BCPMI), a member of the Data Monitoring Committee, ; $599,611), TBI-Prognosis Multicenter Study (PI A. Turgeon,
Ferring Pharmaceutical, Saint-Prex, Switzerland (Selepressin as $303,000). Dr. Reynolds serves as a committee member of the
CCCTG communication committee. He had 2 peer-reviewed
first vasopressor in septic shock), a member of the Advisory
publications and 2 book chapters in 2012. He is the acting head
Board, Albumin in critical care (Grifols, Barcelona, Spain), and
of critical care research in the Fraser Health Authority.
a member of the Advisory Board, Astra Zeneca (Anti-TNF in
sepsis).
Clinical Activities
Dr. David Sweet helped lead a team of Anaesthesiologists,
The ICUs at St. Paul’s, Vancouver General, and Royal Columbian
Burn Surgeons, Intensivists and Emergentologists to develop
Hospitals continue to experience an increase in occupancy and
Burn Guidelines based on a current review of literature and
evidence (Development of Provincial Severe Burn Management workload. Division members from St. Paul’s, Vancouver General
Guidelines). He also, with Drs. M. Vu, D. Griesdale, G. Finlayson, and Richmond Hospitals participate, under the direction of Dr.
Dean Chittock, as members of the VCH Regional Critical Care
E. Vu, R. Brown, V. Dhingra, S. Gregory, A. Papp, published,
Council and continue to develop and implement strategies to
“Provincial clinical guidelines for the management of major
improve the delivery of critical care services within the region.
burn trauma.” This received the best poster presentation at
The goal of the Regional Critical Care Council is to improve
the Canadian Critical Care Conference in Whistler, BC, was the
access, patient flow and sustainability through appropriate
in the top 3 poster presentations at the Critical Care Transport
design and efficiencies and to implement best practices to
Medicine Conference in Nashville Tennessee, and received
improve health outcomes.
best poster presentation at the American Burn Association
Conference in Seattle, Washington. Dr. Sweet is currently
working on 4 research projects. He had 8 publications in 2012. Dr. George Isac continued as Medical Director of the ICU at
Vancouver General Hospital and Drs. Ayas and Sirounis continue
to oversee the clinical operations at Providence Health Care
Dr. John Tsang continues to be a member of the UBC Clinical
(both at St. Paul’s Hospital and Mt. St. Joseph’s Hospital). Dr.
Research Ethics Board (CREB) (since 2008), and has reviewed
Sean Keenan continued as the Program Medical Director for
the Program of Critical Care in Fraser Health and as Regional
Department Head for the Department of Critical Care. Dr.
Steven Reynolds continued as the Local Department Head of
the ICU at Royal Columbian Hospital, Dr. Grant McCormack as
Head of the ICU at Surrey Memorial Hospital, Dr. Greg Martinka
as Head of the ICU at Richmond Hospital, and Dr. Ryan Foster
as the Medical Director of Critical Care for Kelowna General
Hospital and the Interior Health Authority.
As Physician Program Director and Operations Leader in the
ICU at Providence Health Care (St. Paul’s and Mt. St. Joseph’s
Hospitals), Dr. Demetrios Sirounis continued to sit on several
committees including PHC Medical Advisory Committee (MAC),
Clinical Leadership Team, Quality, Patient Safety & Clinical
Risk Management Senior Leadership Team, Provincial ECLS
(Extra Corporeal Life Support) Group, Regional Critical Care
Council; and physician lead for the High Acuity Unit CrossProgram Steering committee and CardioQ Esophageal Doppler
Monitoring in Acute Care setting. Dr. Sirounis is one of 2
physicians in Vancouver, and one of only 6 physicians in British
Columbia who holds the title FASE (Fellow of the American
Society of Echocardiography) presented to him in 2012.
Dr. Griesdale is the Medical Director, Respiratory Therapy at
Vancouver General Hospital.
Dr. Dhingra was appointed a new role as Medical Director of
Quality, Critical Care, at Vancouver General Hospital. He also
served as a member of the Vancouver Acute (VA) Hand Hygiene
Working Group, VA Quality Council and VA Quality Executive.
Dr. Sean Keenan continued work with the BC Working Group and
as a BCSCCM representative.
34
ENDOCRINOLOGY
The Division’s academic half day has been
improved to include regular resident, fellow,
and staff presentations. The program director
has worked with the residents to improve the
content of presentations and incorporate outside
speakers, such as radiology, pathology and
biostatistics. The program has instituted written
examinations for all rotating residents to allow
them to self-evaluate their endocrine knowledge.
All exams are followed by an education
session, supervised by an endocrine fellow. The
program has also started an endocrine physical
examination session, once per teaching block, to
improve rotating resident examination skills.
Division Members
Professor
Dr. Gordon Francis
Dr. Jerilynn Prior
Dr. Ehud Ur
Clinical Professor
Dr. Marshall Dahl
Dr. Hugh Tildesley
Professor Emeritus
Dr. Keith Dawson
Dr. G. Ted Wilkins
Associate Professor
Dr. Tricia Tang
Dr. Richard Bebb
Dr. Tom Elliott
Dr. Sabrina Gill
Dr. David Kendler
Dr. Breay Paty
Dr. Sandra Sirrs
Dr. Michelle Fung
Dr. Michelle Johnson
Dr. Jason Kong
Dr. Stuart Kreisman
Dr. David Thompson
Dr. Adam White
Associate Members
Dr. Dale Clayton
Dr. Diane Finegood
Dr. Charlotte Jones
Dr. Jennifer Klinke
Dr. Julie Lee
Dr. Priya Manjoo
Dr. Harvey Marshall
Dr. Robert Mase
Dr. David Miller
Dr. Barbara Priestman
Dr. Ben Schroder
Dr. Naomi Severin
Dr. David Shu
Dr. Sara Stafford
Dr. Agnieszka Zelichowski
35
Research
Dr. Ehud Ur
Professor and Head
Research activity in the Division of Endocrinology
spans a wide range of areas in basic as well
as clinical research. Most division members
are involved in research activity at some
level, from members whose job description is
Division Overview
primarily as researchers (Francis, Prior, Tang), to
others involved in some way in investigator- or
The Division of Endocrinology has expanded to
industry-initiated basic and clinical research.
include four associate members from Surrey
The areas of research expertise in the division
Memorial Hospital, in addition to our existing
are broad and include: 1) lipid and lipoprotein
associate members from the Royal Columbian
metabolism at the basic and clinical level;
Hospital, B.C. Childrens Hospital and the Royal
2) diabetes mainly at the clinical level in
Jubilee Hospital. The Division is also in the process
multiple areas including type 1 and type 2
of hiring two new endocrinologists to work at
diabetics, specific ethnic populations, drug
St. Paul’s (with a focus on pituitary diseases) and
therapy, cardiovascular risk reduction, and islet
Vancouver General Hospital (with a focus on
diabetes). Dr. Gordon Francis continued as Research transplantation, complementing the broad basic
science expertise in diabetes among other UBC
Director, providing mentorship to trainees during
their research rotation and has organized an annual researchers; 3) hormonal control of ovulation
and postmenopausal symptom treatment
Research Fest for the Division and invited guests.
plus reduction of fracture risk; 4) osteoporosis
Division members have been active in research
assessment, treatment and prevention. Areas
throughout 2012, presenting at numerous national
that the division would like to increase both
and international endocrine and diabetes meetings
The research nurse hired for the neuropituitary clinic clinical and research expertise and activity in
is in her second year, providing educational support include pituitary and thyroid disease. Several
division members are also co-authors on national
for patients, and has continued to work on creating
assessment and treatment guidelines for
a pituitary registry for patients with pituitary
diabetes, lipid disorders and cardiovascular risk,
disorders in B.C. We are also continuing our efforts
at establishing a universal EMR which will serve as a obesity, and osteoporosis.
basis for research for all division members.
Clinical Activities
Education
The Division of Endocrinology provides
consulting services to Vancouver General,
The Division actively participates in undergraduate
St. Paul’s and BC Women’s Hospitals. We
teaching, including the 2nd year undergrad
curriculum (FMED), 3rd and 4th year undergraduate also are involved in a number of specialized,
multidisciplinary outpatient clinics:
electives and formal teaching sessions to senior
students throughout the year. The Fellowship
• Diabetes Centres: Vancouver General, St
Program is Royal College accredited and has
Paul’s, Hospital BC Women’s
expanded to a total of 3 new positions per year, the
•
Prevention Clinic (formerly “Lipid Clinic”): St
largest number of residents in the history of the
Paul’s Hospital
Division.
•
•
•
•
•
36
Metabolic Bone Disease (Osteoporosis): B.C. Women’s
Hospital
Adult Metabolic Diseases Program: Vancouver General
Hospital
Thyroid Clinic: St. Paul’s Hospital
Pituitary Clinic: St. Paul’s and Vancouver General Hospital
Gestational Diabetes Clinic: B.C. Women’s Hospital
GASTROENTEROLOGY
Division Members
Professor
Dr. Hugh Freeman
Dr. Urs Steinbrecher
Dr. Eric Yoshida
Clinical Professor
Dr. Michael Byrne
Dr. Robert Enns
Dr. James Gray
Dr. Lawrence Halparin
Dr. Alan Weiss
Dr. Hugh Chaun
Dr. Stan Stordy
Associate Professor
Dr. Baljinder Salh
Dr. Isabella Tai
Affiliate Associate Professor
Dr. Paul Winwood
Associate Professor Emeritus
Dr. Frank Anderson
Dr. Walter McDonald
Dr. Nazir Chatur
Dr. Martin Fishman
Dr. W.C. Peter Kwan
Dr. Eric Lam
Dr. Alnoor Ramji
Dr. Jennifer Telford
Dr. Jack Amar
Dr. Kenneth Atkinson
Dr. Brian Bressler
Dr. Justin Cheung
Dr. Siegfried Erb
Dr. Jin Kee Ho
Dr. Hin Hin Ko
Dr. Cassie Lin
Dr. David Pearson
Dr. Robert Melville Penner
Dr. K. Craig Render
Dr. Ranjit Andrew Singh
Dr. John Scott Whittaker
Dr. Iman Zandieh
Clinical Instructor
Dr. Henry Chung
Dr. Darin Krygier
Dr. Taralyn Dianna Picton
Dr. Justin Shah
Dr. Janakie Singham
Dr. Victor Wong
Associate Member
Dr. Alan Buckley
Dr. Sharlene Gill
Dr. Stephen Holland
Dr. Kathy Kozial
Dr. Kwok Yik
37
Dr. Eric Yoshida
Professor and Head
Divisional Overview
The UBC Division of Gastroenterology consists of
the faculty of the two main teaching hospitals,
Vancouver Acute (Vancouver General Hospital and
UBC Hospital), and St. Paul’s Hospital (Providence
Healthcare). The Division also has faculty members
at the distributed sites including Richmond General
Hospital, Royal Columbian Hospital and Lion’s Gate
Hospital in the Lower Mainland, the Victoria and
Vancouver Island Hospitals, in Kelowna and the
University Hospital of the North in Prince George.
The faculty consists of both GFT and Clinical Faculty
Association members. There are also associate
members who are located in the distributed sites
as well as associate members who share areas of
academic interest in common with the Division
of Gastroenterology and are members of other
Divisions. The Division has four emeritus faculty
members.
Clinical Services
Full clinical in-patient and out-patient services are
provided at the teaching hospitals as well as the
distributed hospital sites. In particular, the main
teaching hospitals, Vancouver General Hospital
and St. Paul’s Hospital are provincial quarternary
hospitals and are the main destinations for patient
transfers from community hospitals throughout
BC and the Yukon Territories via BC Bedline and
the “Life, Limb or Transplant” policy. Specialized
therapeutic endoscopy consisting of ERCP, both
diagnostic and therapeutic, is offered as a clinical
service at the Vancouver General Hospital, St.
Paul’s Hospital and Royal Columbian Hospital
sites in the lower mainland and at the Victoria
Hospital Corporation institutions. The specialized
modalities of endoscopic ultrasound and capsule
endoscopy are available at St. Paul’s Hospital
and Vancouver General Hospital. Endoscopic
ultrasound is also available at the BC Cancer
Agency Vancouver Clinic and is performed
by VGH faculty with cross-appointments (Dr.
Alan Weiss and Dr. Michael Byrne). As well,
the Division is involved in clinical activity with
British Columbia Transplant and the British
Columbia Cancer Agency (PHSA). The BC
Hepatitis Program, which is a partnership of
the BC Centre for Disease Control and the UBC
Division of Gastroenterology, is actively involved
in clinical services related to viral hepatitis and
liver disease. It is located within the Division of
Gastroenterology’s block in the Diamond Health
Care Centre of the Vancouver Hospital. The St.
Pauls’ Hospital group, Pacific Gastroenterology
Associates, also offers specialized out-patient
care in luminal gastroenterology and viral
hepatitis. In terms of long-term nutritional
support and care, the Province’s Home Enteral
and Parenteral Program is based at St. Paul’s
Hospital under the leadership of Dr. J. Scott
Whittaker who is the Medical Director of the
Program.
Teaching
Undergraduate
The Division of Gastroenterology is an active
participant in the GI Block of the 2nd year
undergraduate curriculum (FMED 424). Division
members, including members in Victoria, provide
lectures to the undergraduate class as well as
participate as preceptors in the problem-based
learning sessions as well as the hepatology
seminars. Drs. Jin Kee Ho and Iman Zandiah
are the Block Co-Chairs and Drs. Peter Kwan,
Bill Salh, Fergal Donnelan and Eric Yoshida are
Week/Co-Week Chairs for FMED 424. Dr. Paul
Winwood co-ordinates UBC’s Northern Program’s
involvement in FMED 424 .
The division members at both the St. Paul’s
Hospital and Vancouver General Hospital sites
have been actively involved in the 2nd year
bedside examining skills course as well as
3rd and 4th year undergraduate selectives .
Ambulatory clinical instruction out-patient, office
setting, clinics are offered to the undergraduate
class yearly during their gastroenterology
selectives. Dr. Nazira Chatur is currently
the Undergraduate Program Director for
Gastroenterology for these clinical years.
Postgraduate
The Division of Gastroenterology has a strong Gastroenterology
fellowship training program. The core program consists of
three senior GI Fellows, Drs. Nancy Fu, Greg Rosenfeld and John
Wong and three junior Fellows, Drs.Yuan Yuan Chen, Rohit Pai
and Majid Al Sahafi. Drs. Nancy Fu and John Wong are also
the appointed Chief Gastroenterology Fellows. The training
program has many applicants both internally and externally each
year and competition for GI fellowship positions has become
increasingly fierce. Dr. Nazira Chatur is the Program Director
and Dr. Peter Kwan is the Associate Program Director as well as
a Fellowship Training Committee that includes representation
from both teaching hospitals, the community group and a
trainee representative. The training committee members, aside
from Drs. Chatur and Kwan, include Drs. Greg Rosenfeld (Fellow),
Alnoor Ramji, Eric Lam, Bill Salh, Marty Fishman, Justin Cheung,
Fergal Donnellan and Eric Yoshida. The GI fellowship training
program has full accreditation from the Royal College.
The Division of Gastroenterology offers specialized training
programs beyond the core Royal College Gastroenterology
Fellowship Program. For many years we have had the liver
transplantation and hepatology training program based at
the Vancouver General Hospital in association with the BC
Transplant Society. The 2012-13 Fellow is Dr. Saad Al Kowaiter
(Kingdom of Saudi Arabia). The Division of Gastroenterology
also has a formal therapeutic endoscopy training program.
Drs. Rob Enns and Mike Byrne are the co-directors. All the
therapeutic endoscopists of St. Paul’s Hospital and Vancouver
General Hospital are involved in this including Drs. Eric Lam,
Jennifer Telford, Urs Steinbrecher and Alan Weiss. The
therapeutic endoscopy training program involves diagnostic
and therapeutic ERCP and endoscopic ultrasound. The current
Therapeutic Endoscopy Fellow are Drs. Nawal Al Nahdi Sheraiser
(United Arab Emirates) and Edward Kim (UBC). Dr. Brian Bressler
has created a UBC Fellowship in Inflammatory Bowel Disease
that will begin its inaugural year in 2013. Dr. Greg Rosenfeld will
be the inaugural IBD Fellow.
and international CME events including the telerounds of the
Canadian Association of Gastroenterology, Canadian Digestive
Diseases Week (the annual meetings of both the Canadian
Association of Gastroenterology and the Canadian Association
for the Study of Liver) and conferences organized by out of
province universities. Dr. Robert Enns, Brian Bressler, Alnoor
Ramji, James Gray, Michael Bryne and Eric Yoshida give many
CME lectures in BC Numerous CME lectures were provided by
the other Division members for local organizations including the
BC Centre for Disease Control, Gut Club, as well as local hospital
rounds and lectures.
Administration
Clinical Academic Special Programs
The UBC Division of Gastroenterology members are involved in
several specific and specialized clinical academic programs. Dr.
Alan Weiss is a member of the BC Cancer Agency Hepatoma
Program. Both Dr. Weiss, Dr. Siegfried Erb and Dr. Eric Yoshida
are involved in multi-disciplinary hepatoma rounds that
include the UBC Division of Gastroenterology, the UBC Division
of General Surgery, and the Vancouver General Hospital
Department of Interventional and Abdominal Radiology. This
multi-disciplinary group is involved in clinical decision making
for hepatocellular carcinoma cases referred from communities
throughout the province. It is also involved in clinical research in
the area of liver cancer.
Drs. Erb, Steinbrecher and Yoshida (Medical Director) are
members of the Liver Transplant Program of the Vancouver
General Hospital. This provincial program provides clinical
care to post-liver transplant recipients, assessment of endstage liver disease patients referred to the progrma, as well as
administrative leadership both at a provincial and national level
and both clinical/basic science research in the field.
The BC Hepatitis Program, which is a partnership of the BC
Centre for Disease Control and UBC Division of Gastroenterology,
is situated within the Division of Gastroenterology’s block in
the Diamond Health Care Centre of the Vancouver Hospital.
Its members include Drs. Erb, Steinbrecher, Kwan, Weiss, and
Yoshida (Head of the BC Hepatitis Program). The BC Hepatitis
Program staff includes Ms. Jo-Ann Ford (Associate Director),
Ms. Kerri Earnshaw, Sarah Ho (hepatitis nurses) and Messrs.
Continuing Medical Education
The UBC Division of Gastroenterology has organized several CME Kirby Lau, Jeff Lin, Ms. Victoria Kan and Dr. Marisa Guan (clinical
research assistants). The program is involved in clinical care and
conferences and both the Vancouver General Hospital and St.
patient teaching in the area of viral hepatitis. The BC Hepatitis
Paul’s Hospital Divisions organize a weekly Gastroenterology/
General Surgery/Radiology/Pathology multi-disciplinary rounds Program is actively involved in clinical research with industry
sponsored clinical trials and non-industry sponsored clinical
that are accredited for the Royal College of Physicians and
studies. There are close collaborative research partnerships
Surgeon Maintenance of Competence Program. The UBC
with BCCDC and the UBC Virology Laboratory. The BC
Division of Gastroenterology also organized the 17th Annual
Hepatitis Program is actively involved in continuing education
Digestive Diseases Week Review for sub-specialists including
at all levels and has organized CME events. It is also involved
gastroenterologists and general surgeons from throughout
BC. This event was very well attended and received favourable actively in nursing education and is part of the UBC Faculty of
Pharmaceutical Sciences PharmD program with preceptorship of
comments from attendees. The St. Paul’s Hospital Division
organizes the annual GI Forum that features live endoscopy and clinical rotations as well as the provision of formal class lectures.
At the national level, Ms. Jo-Ann Ford is the Past President of
speakers from across Canada and the United States.
the Canadian Association of Hepatology Nurses and Dr. Eric
Yoshida is the Past President of the Canadian Association for
Many of our division members have participated in national
Experimental Medicine
Dr. Bill Salh co-ordinates the gastroenterology aspects of the
Experimental Medicine program at UBC. The program involves
graduate students registered in Experimental Medicine as well
as summer students and post-doctoral fellows.
38
the Study of Liver (CASL) and has served on the CASL Governing
Board for 11 years. The BC Hepatitis Program has been involved
with the Canadian Liver Foundation and Ms. Ford and Dr. Eric
Yoshida serve on the National Board of Directors. Dr. Yoshida
is the Chair of the Canadian Liver Foundation Medical Advisory
Committee.
Research
The faculty of the Division of Gastroenterology are very
involved in both clinical and basic science research. Drs. Salh,
Steinbrecher and Tai are actively involved in basic science
research programs supported by national and provincial
granting agencies including CIHR, HSFC, CCFC, and the Canadian
Society for Intestinal Research (CSIR). Clinical research is very
strong within the Division of Gastroenterology and appears
to be expanding. The specific areas of clinical research within
the Division have encompassed: liver disease, viral hepatitis,
hepatocellular cancer, liver transplantation as well as solid organ
transplantation and donation, inflammatory bowel disease
and therapeutic endoscopy. Dr. Rob Enns is the Director of
the Gastrointestinal Research Institute located at the Pacific
Gastroenterology Associates office block. Dr. Enns is also
actively involved in non-industry clinical research and has
developed outstanding clinical research expertise in capsule
endoscopy and therapeutic endoscopy. He has published
many publications this year in these areas Dr. Eric Lam is also
actively engaged in clinical research in the field of endoscopic
ultrasound. Dr. Brian Bressler is establishing a clinical research
program in inflammatory bowel disease. At Vancouver General
Hospital, Dr. Hugh Freeman continues to be a prolific author
of many clinical research papers in inflammatory bowel
disease and celiac disease. The BC Hepatitis Program and
the Liver Transplant Program of VGH have been very active
in clinical research both in industry sponsored clinical trials
and non-industry sponsored clinical studies. The Division of
Gastroenterology at Vancouver General Hospital has also
created a separate Luminal Gastroenterology Clinical Trials Unit
under the leadership of Drs. Michael Byrne, James Gray and Bill
Salh with Ms. Cindy Cheong-Lee as the Research Manager of the
unit. It is expected that clinical research will continue to expand
at both the main teaching hospitals and is a major strength of
the Division
Special Honours, Awards and Distinctions
Notable Service to the University and the Community
Hugh Freeman and Urs Steinbrecher are on the Editorial
Board of the journal. Drs. Michael Byrne, Hugh Freeman and
Eric Yoshida are on the Editorial Board of the World Journal
of Gastroenterology and Dr. Freeman is the Associate Editorin-Chief of the “Observations” section of the World Journal.
Dr. Byrne is on the Editorial Board of the Internet Journal of
Gastroenterology andis an Editorial Consultant for the Physicians
Information and Education Resource (PIER) published by the
American College of Physicians. Dr. Urs Steinbrecher is a
member of the editorial board of the Journal of Lipid Research.
Dr. Hugh Chaun is the President of the Bockus Internal
Society of Gastroenterology and continues to serve as the
Society’s Secretary General. Dr. Chaun is also the Secretary
Treasurer of the Canadian Digestive Health Foundation. Dr.
Michael Byrne and Dr. Eric Lam are members of the National
Endoscopy Committee of the Canadian Association of
Gastroenterology which has Dr. Rob Enns as the Committee
Head. Dr. Enns is the Vice President of the Canadian Association
of Gastroenterology, Clinical Affaires and is the Head of the
Capsule Endoscopy Special Interest Group of the American
Society of Gastrointestinal Endoscopy. He is also on the Board
of Directors of the Canadian Digestive Health Foundation. Dr.
Jennifer Telford is the Medical Director of Colon Check of the
BC Cancer Agency. Dr. Alnoor Ramji is a member of the Blood
Bourne Infectious Diseases Committee of the BC College of
Physicians and Surgeons and serves on the Gastroenterology
Specialty Committee of the Royal College of Physicians and
Surgeons of Canada. Dr. James Gray is a Co-Founder and
Honourary Vice Chair, as well as Chair of the Medical Advisory
Committee, of the Canadian Society for Intestinal Research
(CSIR). Drs. Nazira Chatur is an examiner for the Western
Canadian Trainee Examinations in Gastroenterology (annual
preparatory examination for the Royal College of Physicians
and Surgeons specialist examination in gastroenterology). At
Royal Columbian Hospital, which is the third teaching hospital
in the lower mainland, Dr. Justin Cheung is the Head of
Gastroenterology for the Fraser Health Authority. In Prince
George, Dr. Paul Winwood is Head of Medicine of the University
Hospital of the North and is on many committees including the
Endoscopy Steering Committee of UHNBC. Dr. Winwood is the
academically highest ranking gastroenterologist in this Division
as he is the Regional Associate Dean, Northern BC and the Vice
Provost, Medicine.
In terms of community service, many Division members
have given lectures at public forums on aspects of luminal
gastroenterology and liver disease. Drs. Enns, Jennifer Telford,
Many Division members serve on UBC, BCMA and other
provincial committees and many Division members have served Peter Kwan and Yoshida have also worked with the print media,
radio and television with regards to health-care issues that
as reviewers of numerous Canadian and international peeraffect the residents of BC. Dr. Martin Fishman is on the Board
review journals and grant funding agencies. Dr. Eric Yoshida is
the Deputy Editor of the Canadian Journal of Gastroenterology of Governors of King David High School in Vancouver and is
(official journal of the Canadian Association of Gastroenterology the President of the BC Society of Gastroenterology, Dr. Hugh
Freeman is on two committees for a public parks board on
and the Canadian Association for the Study of Liver) and
Bowen Island.
Associate Editor of the Annals of Hepatology (official journal
of the Mexican Association for the Study of Liver, the Latin
American Association for the Study of Liver and now an official Special Honours and Awards
journal of the Canadian Association for the Study of Liver) and
Internet Journal of Gastroenterology. Dr. Bill Salh is an Associate Dr. Brian Bressler was the recipient of the Heroes Award from
the Crohn’s and Colitis Foundation of Canada, BC Chapter.
Editor of the Canadian Journal of Gastroenterology and Drs.
39
Dr. Eric Yoshida was honoured by the Happy Liver Society
(registered charity) at their annual Gala. Dr. Yoshida was also
inducted into Fellowship of the Canadian Academy of Health
Sciences. Both Ms. Jo-Ann Ford and Dr. Eric Yoshida were the
recipients of the Queen Elizabeth II Diamond Jubilee Medal.
Special Tributes
In remembrance of the outstanding teaching contributions of
the late Dr. Donald M. Carr, who was our beloved colleague
and clinician, the Division of Gastroenterology at Vancouver
General Hospital created the Donald M. Carr Teaching Award to
be given to the “Best VGH Faculty Teacher” as selected by the GI
fellows, medical residents and medical students rotating through
gastroenterology. The 2011-12 recipient was Dr. James R. Gray
medical school and the medical residency training program,
and for the province of British Columbia given the significant
overall economic benefits of dedicated and sustained research
programs. Lastly, the Division hopes to enhance future
collaborations with other Departments within the Faculty of
Medicine (including the Department of Surgery, the Department
of Radiology, Department of Laboratory Medicine and Division
of Pediatric Gastroenterology),with other Divisions within the
Department of Medicine, and with other health-care institutions
within BC and the rest of Canada.
In honour of his outstanding contributions to Gastroenterology
at UBC and throughout the Province of British Columbia, the
UBC Gastroenterology Fellows created the Dr. Hugh Chaun
Mentorship Award. Dr. Brian Bressler was named the recipient
for 2011-12.
The Hoffman Laroche Award for best lecture at the UBC GI
Training Program’s Academic Quarter Day was given to Dr. Hin
Hin Ko.
Trainee Awards
After 15 years, AstraZeneca Canada withdrew their sponsorship
of the Gastroenterology Medical Residents Award and the
award has been retired . Dr. Edward Kim was the Chief
Gastroenterology Fellow 2011-12 and received a plaque from
the Division for his outstanding work.
Future Directions
From a clinical perspective, there continue to be many
challenges facing the Division, including dwindling out-patient
resources in the face of demand that is increasing yearly, and an
increasing demand for in-patient admission/consultation via the
Emergency Department, the hospital wards and inter-hospital
transfers via BC Bedline. This is a particular source of concern
for the VGH Division. At the VGH site fund-raising with the
Vancouver General Hospital Foundation continues to be a major
and necessary activity to purchase equipment for the hospital
and division private funding
Academically, the development of an Academic Financial Plan
(AFP) by the University of British Columbia and the Government
of BC would greatly enhance the Division of Gastroenterology’s
academic productivity and ability to compete with other
Canadian centres. Without an AFP, the future academic viability
of the UBC Division of Gastroenterology will be compromised
significantly. If the current model continues, future productivity
will be entirely contingent on the dedication and willingness
of individual faculty members to engage in such activity to
the detriment of their personal economic situations. This
will only contribute to an environment of academic instability
with long-term uncertainty. This situation is not unique
to Gastroenterology and is true of all Divisions within the
Department of Medicine. This should be a concern for this
University, especially given the expansion of the undergraduate
40
GENERAL INTERNAL MEDICINE & COMMUNITY
INTERNAL MEDICINE
toxicology (Dr. Jim Kennedy). Two members do
echocardiography as part of their practice (Drs.
David Kincade and Dr. JP Lim).
Division Members
Professor
Dr. Dawn DeWitt
Dr. Kevin Eva
Dr. Anita Palepu
The General Internal Medicine division
provides consultation and ongoing care to
a wide variety of patients. This may take
place in an inpatient setting (clinical teaching
unit), consultation service to inpatients,
perioperative service or an ambulatory setting.
Clinical Professor
Dr. Barry Kassen
Dr. Robin Lowry
Dr. Iain Mackie
Dr. Laura Magee
Dr. John Onrot
Dr. Juan Ronco
Associate Professor
Dr. Rose Hatala
Dr. Nadia Khan
Dr. Richard Arseneau
Dr. Hector Baillie
Dr. Wee Shian Chan
Dr. Stephanie Ensworth
Dr. Victor Gray
Dr. Philippa Hawley
Dr. Cheryl Holmes
Dr. Shahin Jaffer
Dr. James Kennedy
Dr. Phillip Malpass
Dr. May Ong
Dr. J. Mark Roberts
Dr. Stephen Sullivan
Dr. Shannon Walker
Dr. Steven Wong
Clinical Assistant Professors
Dr. Abdalla Hassan Abdalla
Dr. Mir Ali
Dr. Yasemin Arikan
Dr. Edward Auersperg
Dr. Khalid Bashir
Dr. Matthew Bernard
Dr. Sarah Broder
Dr. James Busser
Dr. Brian Chai
Dr. Alex Chan
Dr. David Chandler
Dr. Nora Cummins
Dr. James Dunne
Dr. Chad Dyck
Dr. Francis Ervin
Dr. Ryan Foster
Dr. Shavinder Gill
Dr. Abu Obeida Hamour
Dr. Zafar Iqbal
Dr. Gerald Karr
Dr. Mehdi Keshmiri
Dr. Donald MacRitchie
Dr. Christopher Mahony
Dr. Christopher Main
Dr. Anurag Markanday
Dr. Sebouh Matossian
Dr. Tun Zan Maung
Dr. David McDonald
Dr. Jane McKay
Dr. Scott McKee
Dr. Simon Min
Dr. Danny Myers
Dr. David Naude
Dr. Aman Nijjar
Dr. Robert O’Dwyer
Dr. Willie Pewarchuk
Dr. Barrie Phillips
41
Dr. Barry Kassen
Clinical Professor and Head
Division Overview
The UBC Division of General Internal Medicine
and Community Internal Medicine has 83 faculty
members that participate in activities at various
sites including BC Women’s Hospital, BC Cancer
Agency - Vancouver, Vancouver Acute, St. Paul’s
Hospital, Campbell River & District General
Hospital, Kelowna General Hospital, Nanaimo
Regional General Hospital, Lions Gate Hospital,
Penticton Regional Hospital, Richmond Hospital,
Shuswap Lake General Hospital (Salmon Arm),
St. Mary’s Hospital (Sechelt), Victoria General
Hospital, Abbotsford Regional Hospital, Royal
Columbian Hospital and Delta Hospital. The
specific site activities are varied. Members are
involved with Palliative Care (Dr. P. Hawley heads
the program at the Vancouver Cancer Agency),
Obstetrical Medicine (Drs. Laura Magee and Sue
Purkiss at BC Women’s and Children’s Hospital),
HIV care (Drs. Iain Mackie and Jake Onrot), eating
disorders (Drs. Ric Arseneau, Debbie Rosenbaum
and Jane McKay), addiction medicine (Drs. Alex
Chan and Cary Cuncic), Heart Failure Clinic (Dr.
Mark Roberts), UBC Sports Medicine (Dr. Mark
Roberts) at St. Paul’s Hospital and Vancouver
Acute, Community GIM (Victoria General Hospital
– Dr. Laura Farrell, Dr. Jim Spence; Campbell
River – Dr. Jennifer Grace, Penticton – Drs. David
Kincade, Sarah Broder, Shannon Walker, Chad
Dyck; North Vancouver – Dr. Kevin McLeod;
Nanaimo & Outreach – Dr. Mike Kenyon. The
division is also involved with geriatrics (Dr. Bob
Wakefield), and clinical pharmacology (Drs.
James Wright and Tom Perry), as well as clinical
The GIM physicians provide expertise,
core teaching and research in addiction
medicine, pain management, eating disorders,
hypertension, HIV management, drug and
poison control and hemochromatosis.
One of the division members is involved
in scleroderma research and patient
management.
Our members are program leaders in medical
education, research and administration and
are recognized locally and nationally in these
areas.
Our membership has an emphasis on medical
informatics and has strong well-recognized
leadership in these areas. Dr. Ric Arseneau
(development of web evaluation, etc), Dr.
Jim Busser (development of CTU Tracker) and
Dr. Ken Cunningham (online medical grand
rounds) are the active members currently.
Medical Education
The core element for general internal medicine
is teaching in a variety of settings, whether
this is classroom, seminar, small groups,
clinical inpatient or outpatient services or with
simulation. We teach at all sites. Our clinical
care and teaching are usually synonymous.
Virtually all clinical services have an educational
component as trainees are generally involved.
Dr. Mark Roberts is director of the Department
of Medicine Postgraduate Program and is
supported by 2 co-directors, one of whom is
Dr. Rose Hatala, a division member. Dr. Hatala
manages the evaluation portfolio of the program.
The core internal medicine program oversees the
training of over 150 residents.
Dr. Roberts heads the Clinical Teaching Unit
at Vancouver General Hospital (VGH) and Dr.
Kassen heads the St. Paul’s Hospital (SPH)
Clinical Teaching Unit. With the expansion of the
Dr. Susan Purkiss
Dr. Debbie Rosenbaum
Dr. Samantha Segal
Dr. Robert Yih-jen Shaw
Dr. Peter Sherk
Dr. James Spence
Dr. Steven Sutcliffe
Dr. Susan Taylor
Dr. Andrea Tothill
Dr. Arul-Anandam Varadarasa
Dr. Stephane Voyer
Dr. Sara Wadge
Dr. Robert Wakefield
Dr. Dave Williams
Dr. Lawrence Winkler
Dr. Ewa Wojtowska
Dr. Tung Yang
Clinical Instructor
Dr. Erin Bergsma
Dr. Sherri Caswell
Dr. Cary Cuncic
Dr. Kenneth Cunningham
Dr. Sharmistha Das
Dr. Ezz Fam
Dr. Laura Farrell
Dr. Cori Gabana
Dr. Surajit Ghosh
Dr. Gil Kimel
Dr. Anna Kang
Dr. Michael Kenyon
Dr. Jeffrey Kerrie
Dr. David Kincade
Dr. Emily Lai
Dr. Kevin Lai
Dr. Nasim Mahmoudi
Dr. Iain McCormick
Dr. Kevin McLeod
Dr. Harpinder Singh Nagi
Dr. Shelley Perlman
Dr. Shailendra Prasad
Dr. Callum Reid
Dr. Abid Saadeddin
Dr. Doug Skinnider
Dr. Nidhi Sood
Dr. Jennifer Sunderwood
Dr. Penny Tam
Dr. Deanna Teichrob
Dr. Chandana Weerasinghe
42
undergraduate program to the distributed sites,
all undergraduate students in Vancouver are
taught at VGH, SPH or Royal Columbian Hospital.
All of the postgraduate training in CTUs and GIM
clinics are conducted at these sites as well.
Trainees are also mentored in eating disorders,
pain management, HIV and addiction medicine.
We have a strong program in palliative care and
maternal-fetal medicine (using a mentorship
model). The CTU faculty is instrumental in the
International Medical Graduate Program at St.
Paul’s Hospital in both training and evaluation.
Arseneau and Kassen teach on the cardiac simulator
to the undergraduate and postgraduate groups.
Simulation is also used to teach procedures.
Continuing medical education is provided by a large
number of the membership. This is often done on
an individual basis.
Dr. Rose Hatala chairs a subgroup of the division
interested in Medical Education. The group meets
monthly and all fellows and division members are
invited.
Dr. Hatala is active in medical education and
research. She is a leader in CHES and recently as
Drs. Jim Busser and Debbie Rosenbaum are
current directors of the Undergraduate Clerkship well has been collaborating with national and
international research initiatives (medical education/
Program at VGH and SPH respectively.
simulation).
New initiatives have been adopted through the
Dr. Mark Roberts and a fellow, Dr. Callum Reid, have
research and subsequent implementation of
tools such as mini-CEX (research and subsequent been pursuing “point of care” ultrasound. They are
in the process of developing a curriculum to teach
implementation in evaluation of trainees in
these skills to undergraduates, postgraduates and
the CTU setting) and pioneering the use of
faculty. They have presented this work locally and at
simulations in medicine (Drs. Rose Hatala, Iain
national forums.
Mackie, Ric Arseneau and Barry Kassen). The
latter program will teach central line insertion
New Training Sites
(and has used this opportunity to study and
publish in this area), as well as promote learning
Penticton continues to be a training site for Internal
and evaluation using simulation models.
Medicine’s Core Residents. Nanaimo, Victoria and
Lions Gate Hospital have become training sites for
Under the leadership of Dr. Anita Palepu, the
General Internal Medicine Fellowship Program Fellows in GIM. In addition to these sites, internists
from Salmon Arm, Kelowna, Abbotsford and
has expanded and has been very supportive
Campbell River have been added to the division.
of the fellows. Many fellows are pursuing
additional training independent of their clinical
training as part of their fellowship and are doing Research
so locally and at distant sites such as Harvard.
Research is conducted at all sites including VGH,
SPH, BC Cancer and BC Women’s Hospital. There is
Drs. Hatala, Cuncic, Roberts and Kassen are
a core group of funded researchers with dedicated
active medical educators doing research.
CTU heads in the community are as follows: Drs. time for research activities.
Jim Spence (Victoria), Paul Winwood (Prince
George) and Gerald Da Roza (New Westminster). Dr. Anita Palepu is the Vancouver PI for The
Health and Housing in Transition (HHIT) Study:
Drs. Roberts and Kassen are respective CTU
A longitudinal study of health of homeless and
heads at VGH and SPH. The CTUs are similar
with large volumes of acute medically complex vulnerably housed adults in Vancouver, Toronto and
Ottawa (CIHR 2008-2012). Her group has completed
patients. St. Paul’s Hospital has a mandate
the baseline enrollment of 200 homeless persons
to evaluate and teach Royal College Program
and 200 persons who are vulnerably housed in
residents, family practice program and
the single room occupancy hotels, which was a
international medical graduate trainees.
challenging task. They began the first year followup in March 2010 after the Olympics and have
The VGH and SPH sites have also initiated the
undergraduate ambulatory rotation within the been able to achieve ~80% follow-up rate. They are
8 weeks of CTU medicine for 3rd year students. currently doing their second year follow-up.
Victoria, Prince George and New Westminster
Dr. Palepu continues to be the co-editor of Open
are as well initiating ambulatory rotations for
Medicine (http://www.openmedicine.ca), which
MSIs.
is an independent, peer-reviewed, open-access
There have been new education initiatives with general medical journal that publishes high quality
content. She is the department director for the
the use of simulation. Drs. Hatala, Mackie,
Clinical Investigator Program and sits on the CIHR Health
Services Research New Investigator Award Committee.
Dr. Rose Hatala is involved in the following research:
•
•
Medical Council of Canada Grant – “Determining the
utility of the mini-clinical evaluation exercise as a
summative assessment tool of clinical competence: a
multi-centered pilot study”. Principal Investigators: R.
Hatala, R. Sidhu.
2008 RCSC Medical Education Research Grant – “A pilot
study of a modified long-case OSCE format for the high
stakes assessment of clinical performance”. Principal
Investigator: R. Hatala, S. Marr.
Dr. Cary Cuncic is working with Dr. Rose Hatala on a modified
OSCE with the Royal College with the 4th year GIM residents.
Dr. Cuncic is also involved in a qualitative research project with
UBC Faculty Development (The role of the student- preceptor
relationship for enhancing teaching in a longitudinal integrated
clerkship).
Dr. Paul Winwood is the supervisor on a study entitled:
“Do medical students perceive benefit from pharmacist-led
pharmacotherapy tutorials and daily involvement?”. This study
is an evaluation of a new pharmacist-led pharmacotherapy
teaching program on the CTU in the Northern Medical Program
and is run for pharmacy resident Sandra Katalinic. The
methodology involves a satisfaction survey and a pre and post
test of students’ knowledge.
RCPC Study – “Assessment tools for assessment of cardiac Scholarly
physical examination skills”. Co-investigators: R. Hatala,
Dr. Hector Baillie, a general internist from Nanaimo, is editorM. Bacchus, B. Kassen.
in-chief of the periodical Canadian Journal of General Internal
Medicine. Along with being an active advocate for General
• Grant submitted for: “The role of dual reasoning
strategies for learning cardiac physical examination skills”. Internal Medicine, he is in full-time clinical practice in Nanaimo.
Co-investigators: M. Sibbald, R. Hatala, K. Eva.
Drs. Kevin McLeod (North Vancouver), Chad Dyck (Penticton)
and Steve Wong (Richmond) are educational and clinical leaders
Dr. Nadia Khan is very active in social determinants of
in their respective sites.
cardiovascular disease including the impact of ethnicity on
chronic diseases such as cardiovascular disease management
Dr. Jim Spence continues in the role of CTU Director and more
and outcomes. She has received many prestigious supporting
recently associate program director for Internal Medicine in
grants including CIHR and Michael Smith Awards, and has
received the CIHR New Investigator Award, the Genesis Scholar Victoria. He has modified his practice and dedicates much of his
time to teaching and administration for undergraduate medical
Award and the SPH Physician Scholar Award. She has a CIHR
students and residents in medicine and family practice. He has
operating grant exploring gender and ethnic differences in
been awarded a special teaching award by the UBC Medicine
patients with hypertension. Dr. Khan is a member of the
residents. Dr. Spence continues to lead the GIM undergraduate
Canadian Hypertensive Society Education and Research
and postgraduate IM experience in Victoria and has joined the
Group. She also serves as a scientific committee member of
Postgraduate Residency Training Program.
the Heart and Stroke Foundation Trainee Award Program and
a CIHR operating grant peer-review committee. She has been
successful in obtaining competitive operating grant funding from Since his appointment, Dr. Winwood’s university time has largely
been dedicated to teaching, in particular to developing and
CIHR in the most recent competition.
running the Clinical Teaching Unit in the Department of Internal
Medicine at Prince George. He is the Discipline Specific Site
Dr. Laura Magee continues her research in maternal-fetal
Leader (DSSL) for Internal Medicine in the Northern Medical
medicine, concentrating on hypertension in pregnancy and is
Program. This includes a significant administrative role in the
the principal investigator of the CIHR-funded multi-site CHIPS
coordination of teaching and clinical experiences of 3rd year
randomized controlled trial examining these issues of tight
clinical clerks, family practice residents (R1s) and Internal
versus lenient blood pressure control in pregnancy. She has
been highly productive and widely recognized as a leader in her Medicine residents (R2s & R3s). He also chairs regular CTU
meetings with the teaching faculty in Internal Medicine at Prince
field.
George (every 2 to 3 months) for which minutes are kept. The
community members are involved in medical administration for
Medical education research is a focus for Drs. Rose Hatala,
the various hospitals and health care regions. Some members
Iain Mackie, Mark Roberts and Barry Kassen. Previously this
group was awarded a Stemmler Grant (from the National Board are active nationally in the Royal College, with the oral and
of Medical Examiners from the USA) and completed a national written examinations in Internal Medicine, as well as promoting
study. There have been presentations and publications from this the development and the values of General Internal Medicine
in Canada. Drs. Kenyon and Baillie are examiners for the Royal
work. This group has also published their experience with the
development of a quality improvement process for postgraduate College in Internal Medicine.
first year trainees, and have been awarded a Royal College
Grant to continue this work. Follow-up studies are being done The medical school expansion is integral to the promotion of
with the research group of the Royal College Internal Medicine the community division. The capacity to develop new training
sites and new training directions is a primary focus of the GIM
Examination group and involve cooperative studies with
Division’s teaching program.
international colleagues.
•
43
Clinical Services
Inpatient/Acute Medicine
4 educational sessions per year for families of the eating
disordered. We participate in web-cased lectures to 24 ED sites
throughout the province.
The bulk of inpatient acute medicine is in the CTU structure (in
university settings) with most members participating at SPH,
VGH and RCH sites. There is a well an active consultation service
promoted at both St. Paul’s and VGH.
Both VGH and St. Paul’s Hospital have an HIV service. Dr. Iain
Mackie is the director of this service at VGH. Drs. Onrot and
Mackie participate in the inpatient services.
Hypertension
The group’s teaching and educational role is expanding. They
engage medical students, residents and fellows from GIM,
clinical biochemistry and psychiatry in our clinics.
Clinics are held on most days of the week at BC Women’s
Hospital and Health Centre. General and subspecialty
internists (endocrinology and hematology) provide specialist
outpatient and inpatient consultative services to all maternity
care providers, in midwifery, family practice, medical genetics,
The St. Paul’s Hospital Blood Pressure Clinic, operated by Dr. Jake
Onrot, is a multi-disciplinary teaching clinic, operating out of the
Rapid Access General Internal Medicine Clinic. This is a referral
clinic that receives patients from all over the province. Although
the focus is lowering of high blood pressure, the prime goal of
treatment is to reduce the patients’ overall risk factor profile and
improve quality of life. Medical students, residents, fellows in
Addiction
General Internal Medicine, and elective students and residents
from other programs (primarily family practice) are integrated
Dr. Alex Chan has been the lead physician involved in
into the clinic, see patients and receive primarily case-based
substitution therapy trial for persons with refractory addiction
to opiates. The NAOMI Clinic is located on the corner of Abbott teaching in an evidence-based academic environment. Dr.
and East Hastings streets in the heart of Vancouver’s Downtown Onrot is a general internist and clinical pharmacologist with
30 years’ experience in hypertension in clinical, research,
East Side. The clinic began as the site of the NAOMI clinical
teaching, administration and advisory policy areas. He has been
trial of prescription heroin. After the study was completed,
mentoring one of our PGY5, Dr. Cori Gabana, in hypertension.
the NAOMI Clinic remained open as an addiction clinic and is
currently funded by Providence Health Care. The clinic focused Congestive Heart Failure
on providing opioid replacement therapy to people with heroin
Dr. Mark Roberts has a VGH based clinic for the ongoing
addiction who were unable to access other local clinics. The
management of patients with congestive hear failure.
clinic also manages other acute medical problems that are
often associated with substance abuse including soft tissue
HIV
infections, respiratory diseases and psychiatric co-morbidities.
Medical stuff includes nurses, and physicians from Family
Members of the Division of General Internal Medicine
Practice, Internal Medicine and Psychiatry. Social workers and
participate in the care of HIV positive patients at both St. Paul’s
drug counselors also facilitate engagement with psychosocial
Hospital and Vancouver General Hospital. Drs. Mackie and
services including drug counseling and residential recovery
Onrot have joint appointments with the Division of AIDS.
housing programs, free dental programs, food bank, etc. The
NAOMI Clinic also runs an on-site pharmacy to facilitate daily
medication dispensing and encourages engagement with clinic The HIV Clinical Care Program at Vancouver General Hospital is a
staff. Referral sources include St. Paul’s Hospital, the Community joint venture between the Division of Infectious Disease and the
Transitional Care Team, local Vancouver Coast Health clinics and Division of General Internal Medicine. It provides ambulatory
care through the HIV/AIDS Clinic as well as consultation and care
self-referrals.
for hospitalized patients.
Eating Disorders
Dr. Mackie and Onrot also function as consultants for the AIDS
ward at St. Paul’s Hospital, providing expert care to hospitalized
The GIM division has continued to provide medical support
patients and teaching expertise for the residents and medical
to the Tertiary Eating Disorders program. Drs. Arseneau,
Rosenbaum and McKay provide this support. Our service model students who undertake elective rotations on the ward.
has transitioned to a consultation role with psychiatry taking
Perioperative Clinic (SPH/VGH)
on the direct care responsibilities of this group. Their role is
to provide acute care services to the severely unwell eating
There is a newly established clinic at St. Paul’s Hospital. This is
disordered (ED). They also have four outpatient clinics for the
medically unwell ED patient. This year they introduced a multi- done in conjunction with Anesthesia, Surgery and the Division
disciplinary clinic; the Complex Care Clinic. It serves to provide of GIM. Discussions are ongoing at the VGH site to establish
a similar clinic. Both sites see preoperative patients in their
medical (GIM), psychiatric, nutritional and nursing support to
outpatient clinics and provide a rapid access service. The clinics
the province’s sickest ED patients.
are an active training site and will be focus of future research.
The provincial consultation support to family physicians and
Medical Complications of Pregnancy
secondary ED centers continues to thrive.
Their teaching role in the province is expanding; we provide
44
general obstetrics and gynecology, and maternal-fetal medicine.
Consultations cover the breadth of medical disorders in
pregnancy, as well as reproductive toxicology counseling.
Trainees in these clinics are restricted to post-graduate learners,
who attend as part of their ambulatory care rotation in general
internal medicine (UBC) or as part of an on-site elective in
obstetric medicine (UBC and other national and international
institutions). BC Women’s is a stand-alone maternity hospital
and as such, offers trainees the opportunity to assume a high
level of responsibility for patients.
Ambulatory GIM
Ambulatory care is the cornerstone of GIM in the community
with all members participating. Both VGH and St. Paul’s
Hospital have active ambulatory medicine programs which
include a rapid access component. Because of the acute care
commitments at the VGH site the ability to see ambulatory
patients 5 days a week is limited but the clinic is expanding
under the guidance of Dr. Iain McCormick. Royal Columbian
Hospital has a perioperative and active ambulatory clinic (Dr.
Matt Bernard).
The ambulatory general internal medicine services at SPH
continue to be provided through the rapid access clinic at SPH.
Our ambulatory program focuses on providing outpatient care
to the adult patient with complex medical health problems. Our
referral base is growing with a focus on post CTU discharge,
Emergency and GPs in the catchment area of SPH. The
educational role of our outpatient clinic is thriving, providing
educational opportunities to all of the GIM fellows with a
combination of a block rotation and longitudinal clinics. We
continue to have core IM residents in our clinics. Preoperative
consultation is a growing area in the GIM outpatient clinic
spectrum and we hope to increase this service in the future.
Ambulatory MSI Program SPH/VGH
3rd year medical students are introduced to outpatient internal
medicine as a 2 week sub rotation of their CTU training time.
The curriculum development is led by Drs. Arseneau and McKay.
The service and educational components of this program
continue to grow. This initiative has received positive feedback
from the students, clinicians and the Council of Undergraduate
Deans. Funding has been secured to continue to develop this
program in the future.
This program has been incorporated at VGH under the
supervision of Dr. Jim Busser.
Community
The members of the community group provide Internal
Medicine care to their respective communities. These activities
include consultation to hospitals and outpatient groups,
intensive care medicine, acute coronary care unit, pacemaker
clinics, dialysis, perioperative and emergency services. In short,
this group provides the entire spectrum of Internal Medicine
services in many communities throughout the province. The
group’s activities are absolutely essential to the function of all
acute care facilities.
Some of the Nanaimo internists, including Dr. Mike Kenyon,
continue to volunteer and spend time in Kandahar, Afghanistan
working in the field hospital and providing Internal Medicine
services and critical care services to the military and civilians in
this region. Dr. Kenyon also services Northern BC communities
in ACU/GIM and incorporates this with a teaching service for
fellows in GIM and medical residents. Dr. Kenyon’s clinical
rotation is universally well received by the trainees. Dr. Kevin
McLeod has a clinical rotation which involves the LGH and
Whitehorse. Again all residents and fellows find this a very
valuable experience.
Each general internist provides Internal Medicine services to
their community, as well as some specialized care unique to
that individual (e.g., Dr. David Kincade in Penticton provides
echocardiography services).
All of the community general internists teach clinically in
the ambulatory as well as the hospital setting. Many have
leadership roles in their hospitals/communities.
Dr. Kevin McLeod and Danny Myers are leaders in the BCMA
Section of Community and Rural Internal Medicine of BC and are
principle players in developing and promoting remuneration for
our clinical activities (CRIM).
A list of the community internists and their activities will appear
in the next annual report.
Administration, Division Organization and Membership
Members of the division play key roles in administration locally,
provincially and nationally.
Drs. Nadia Khan, Iain Mackie, Jake Onrot and Barry Kassen
are on the Executive of the Rocky Mountain Review Course (a
University of Calgary Internal Medicine initiative) as well as the
executive of CSIM.
Dr. Anita Palepu is the Department Director of the Clinical
Investigator Program, and the Director of the GIM Fellowship
Program. She is the Co-Editor of Open Medicine, an
independent, peer-reviewed open access general medical
journal and Associate Editor at the Annals of Internal Medicine.
Dr. Tom Perry directs the undergraduate program at the UBC
site.
Dr. Mark Roberts is CTU Director at VGH, Postgraduate Program
Director, a member of the GIM Fellowship Training Committee
and a member of the Oral Examination Board of the Royal
College in Internal Medicine.
Dr. Rose Hatala is research director for the Internal Medicine
Examination Committee, was recently appointed Chair for the
English Oral Board for the RCPC, and is a member of the Faculty
45
•
There will be an expansion of the division membership,
with the emphasis on VGH site. This will necessitate
a need for more space at this site. There is an ongoing
review for infrastructure support at this site. Solutions
are being explored.
•
Support and mentoring of new recruits is a prime area
of emphasis for the division. We want our recruits
to be successful clinically and try to minimize their
administrative (and other activities) in their first year. We
work with each of them to introduce and develop their
special skills and interests to enhance the division and the
health care system. We support and mentor curriculum
design, simulation, ultrasound point of care, patient
safety and quality, medical education and assessment and
special areas of expertise.
•
There will be continued emphasis of our alternate
payment system that will reward and enhance the nonclinical activities of the division.
•
We will work to recruit to our division and to recruit
to GIM for the province of BC. We will continue to
emphasize GIM and to emphasize our community
component of GIM. We will promote the new
subspecialty of GIM (at the Royal College).
•
We will continue to be valuable collaborative partners
within the hospitals and health authorities and will
promote the ongoing patient-centered focus for our
division.
•
We will support our fellows and trainees. We will try
and ensure there is the best training for them and that
this training aligns with their professional goals and
objectives. We will try and align these with the health
care needs of British Columbia.
The fellowship program promotes general internal medicine
practice in the community and university setting and is focused
on tailoring the PGY5 training to meet the professional needs of
the fellow.
•
We will continue to support the academic mission of
the division and its members. The development of a
medicine educational group led by Dr. Rose Hatala will be
a major focus for the division.
Future Directions
•
Our division will continue to support the mandate of the
Department of Medicine and to promote scholarship,
citizenship and excellent high quality care the citizens of
British Columbia.
•
Our division will consider new models of health care
delivery.
•
Our division will expand and strengthen our educational
leadership for the undergraduate and postgraduate
training programs.
Development Group in the Faculty of Medicine. Dr. Hatala
also mentors researchers in medical education (in various
departments) and medical educators.
Dr. Jim Busser is clerkship director at VGH and Dr. Debbie
Rosenbaum is clerkship director at SPH. Dr. Dunne is director of
the Scleroderma Clinic at SPH.
Dr. Jane McKay is director of the Ambulatory Care at SPH and
the Provincial Eating Disorders Program. Dr. Iain McCormick
directs the VGH Ambulatory Care Program.
Dr. Barry Kassen is Head, Division of General Internal Medicine
at UBC, VGH and SPH, SPH Associate Head, Department of
Medicine, Acting Division Head, Community Internal Medicine,
CTU Director SPH, Representative to Rocky Mountain and
Canadian Society of Internal Medicine, past Governor of British
Columbia for the American College of Physicians, member of
the UBC Internal Review Committee, past chair of the Internal
Medicine Examination Committee (RCPSC), member of the
Working Group in GIM (RCPSC), member of the Evaluation
Committee (RCPSC), member of the Health and Public Policy
Committee (RCPSC) and member of the International Advisory
Group (RCPSC).
Fellowship Program
Dr. Anita Palepu is the Director for the Fellowship Program in
General Internal Medicine. She has been very successful in
recruitment to the program, which has a strong structure and is
supported by administrative assistance from Betty Cristofoli. The
fellows pursue individualized training in their second year.
The journal clubs continue to be of very high quality and
valuable to the trainees and divisional membership. The twicemonthly scholarly sessions have also been a success and are well
reviewed.
•
•
46
Recruitment of our trained GIM fellows to the community
and university group is a priority we are pursuing actively.
This is recruitment aimed at all sites. There is now
active involvement by the government (postgraduate
administration headed by Libby Posgate). GIM
development and recruitment is a new priority through
the health care system and continues to be an emphasis
of our division.
Development of an outreach program. Presently there is
a pilot site (Williams Lake). This is being developed and
would be the template for other sites. Recruitment to the
division is emphasizing that this is an expected activity of
the new members.
GERIATRIC MEDICINE
Division Members
Professor
Dr. B. Lynn Beattie (Emeritus)
Dr. Graydon Meneilly
Clinical Professor
Dr. Larry Dian
Dr. Roger Wong
Associate Professor
Dr. Kenneth Madden
Dr. Amanda Hill
Dr. Phil Lee
Dr. Patrick Roy Montgomery
Dr. Kathryn Bell
Dr. Maria Chung
Dr. Scott Comeau
Dr. Wendy Cook
Dr. Obid Kahn
Dr. Deviani Maher
Dr. Peter O’Connor
Dr. Caroline Petrossian
Dr. Shunmoogam (Willie) Pillay
Dr. Christopher Rauscher
Dr. Husain Syed
Clinical Instructor
Dr. Kim Barnett
Dr. Marilyn Bater
Dr. Kim King
Dr. Joy Liao
Dr. Lawrence Sheng-Shi Lo
Dr. Marilyn Malone
Dr. Janice Menezes
Dr. Hetesh Ranchod
Dr. Richard Sztramko
Dr. Pamela Thornton
Dr. Diane Villanyi
Dr. Dorothy Williams
Associate Members
Dr. Anastasia Forbes
Dr. Anson Li
Dr. Grant Stiver
Dr. Jocelyn Chase
Dr. Maria Chung
Interim Head, UBC/VGH
DIVISION OVERVIEW
DIVISIONAL AND ADMINISTRATION OVERVIEW
Dr. Amanda Hill
Interim Head, UBC/SPH
Dr. Maria Chung and Dr. Amanda Hill are Acting
Co-Heads of the Division of Geriatric Medicine. A
formal search process for a permanent Head has
commenced.
The Division of Geriatric Medicine has grown
significantly since its inception in the 1980s under
the leadership of Dr. B. Lynn Beattie. Emeritus
Professor Dr. Beattie, as well as being the founding At Vancouver Acute, Dr. Graydon Meneilly is
Head of the Division of Geriatric Medicine, has also the Eric W. Hamber Professor and Head, UBC
been the Clinic Director for the Alzheimer Disease Department of Medicine, and the Physician
Lead at Vancouver Acute. He is Co-Chair of the
and Related Disorders clinic, as well as Research
Regional Medical Council.
Clinician with the Brain Research Center and VCH
Research Institute. She is retiring in 2013, after many
fruitful years of providing leadership, teaching and Dr. Amanda Hill is the Physician Operations
Leader at St. Paul’s Hospital. She also continues
mentoring in both clinical and research fields.
to work on Global Health and has taken the lead
on the Postgraduate Global Health Network
The Division currently provides a wide range of
clinical services as well as teaching across all sites,
including Vancouver/Richmond, Providence, the
Fraser region, Vancouver Island, and the Interior.
These include very active multi-disciplinary as well
as physician only inpatient geriatric consultation
services, in-patient acute care for elders, geriatric
ambulatory care and multiple outpatient clinics.
A number of Geriatricians attend on CTUs in
Vancouver, Providence, and the Fraser, bringing
their knowledge of care of the elderly to trainees
during their Internal Medicine rotations, and
enhancing recruitment opportunities for future
Geriatric Medicine fellows. Geriatricians also
provide outreach to communities in the interior and
northern regions of the province, and provision of
Tele Health is being actively explored through VIHA.
Dr. Janet Kushner-Kow has been appointed
Program Director for Elder Care for Providence
Health Care.
Dr. Maria Chung is Medical Director, UBC
Hospital, and Medical Manager for Sub-acute
Medicine at Vancouver General Hospital, as well
as Director of the SAFE unit.
Dr. Marilyn Malone is Associate Division Head of
the Division of Geriatric Medicine, and Medical
Director for Seniors and Spiritual Health in VIHA,
which includes both Geriatric Medicine and
Psychiatry.
Becky Nagra continues as the Division
Administrative Manager for the UBC, Vancouver
The Division’s major areas of research emphasis
are in health services research, diabetes, dementia, General Hospital and St. Paul’s Hospital sites.
Becky has taken on major responsibility for the
osteoporosis, falls prevention and cardiovascular
educational program, human resources, financial
disease.
47
and divisional issues for the division. In addition, Becky provides The Division also provides rotations for Family Practice Care
of the Elderly physicians, and is in the process of developing
support to the division heads and the division’s academic staff
opportunities for Dental and Geriatric Psychiatry Fellows.
and activities.
EDUCATION
Undergraduate
Dr. Janet Kushner-Kow is the CME Director for the Canadian
Geriatrics Society.
Dr. Janet Kushner-Kow is a member of the Undergraduate
Education Committee overseeing the Third Year Internal
Medicine Clerkship and its distribution to Victoria, Northern
BC and the Fraser Valley. She is also the Faculty Development
Liaison for the Third Year Committee; Week Chair for the Brain
and Behaviour Block in Year Two and organizer for the geriatrics
component of the clinical skills course in Year Two.
Dr. Wendy Cook coordinates the UBC Geriatric Medicine Grand
Rounds, which are telecast weekly throughout the Province.
All of the Division members teach in various components of
problem-based learning and clinical skills, as well as on the
clinical teaching services in geriatrics and internal medicine.
A number of popular Fourth Year electives are offered at
numerous sites in the Vancouver Fraser program. Lectures on
aging are provided for medical students, as well as students in
their Fourth Year of Dentistry.
Dr. Lynn Beattie is involved in the editing of a new textbook of
Geriatric Medicine that will include an online component.
Postgraduate
The UBC Geriatric Medicine Fellowship under the leadership of
Program Director, Dr. Janet Kushner-Kow, continues to be one
of the largest and most successful Geriatric Medicine training
programs in the country.
Several members of the division continue to be active in CME
including national and provincial initiatives in the areas of
dementia, osteoporosis, and cardiovascular fitness as well as
care of the hospitalized elderly.
RESEARCH
Dr. Graydon Meneilly continues his research program in diabetes
and carbohydrate metabolism in older adults. He is a member
of the Canadian Academy of Health Sciences and the Canadian
Association of Professors of Medicine. He has served on
numerous panels, including the Institute Advisory Board of the
CIHR Institute of Aging.
Dr. Ken Madden is currently principal investigator for 6 years
of continuous funding from the CIHR (valued at approximately
half a million dollars), and is co-investigator on 2 other CIHR
Dr. Janet Kushner-Kow is Chair of the Royal College Geriatric
operating grants (value of $450,000) and 1 CIHR team grant
Medicine Examination Committee, and has been involved in
the transition to Standardized Clinical Examinations (StaCERs): a (value of $2 million dollars). He has demonstrated an increasing
international profile, and has been asked to speak and organize/
context-specific real-life evaluation method to ensure geriatric
chair a session at the Society for Clinical Trials meeting, as
medicine trainees demonstrate clinical competencies.
well as review abstracts for the Gerontological Association of
America meeting. He has presented his research at a number of
Dr. Wendy Cook was appointed Associate Program Director
gerontological and diabetes meetings, and was asked to judge
- Curriculum for the UBC Postgraduate Internal Medicine
abstracts and chair a session at the Canadian Cardiovascular
Program.
Congress. He has published 9 peer reviewed articles and 5
peer- reviewed abstracts in 2012. He is a reviewer for numerous
Dr. Roger Wong was confirmed Assistant Dean, Postgraduate
scientific journals, including the Journal of Applied Physiology,
Medical Education, UBC Faculty of Medicine.
and was a member of a CIHR peer review committee, and
Dr. Amanda Hill, in collaboration with Dr. Graydon Meneilly and the CIHR Age-Plus Prize committee this year. He provides
mentorship in research to fellows, residents and a Masters’
other physicians, continues to develop the Internal Medicine
Residency International Health Project. This partnership allows candidate. He is also chair of the Scientific Program for the
Canadian Geriatrics Society annual meeting.
residents and attending staff to experience a very different
Vancouver Island Health Authority (VIHA) welcomed a new
practice of medicine by working at hospitals in developing
Scholar in Residence, Brenda Parke, who brings CIHR funding
countries.
for health services delivery research in VIHA along with the
Centre of Aging at the University of Victoria. The project
All Division members continue to be actively involved in the
“Understanding Emergency Department Care Transitions for
teaching of Internal Medicine Residents and Fellows in the
Older Adults with Dementia in Rural Communities” is now
principles of the care of the frail elderly, including the Clinical
underway. The EXTRA project entitled “Patient Engagement in
Teaching Units and Noon Rounds for medical residents in
Care Decisions” is scheduled for completion in July 2013. This
Vancouver, Richmond, Fraser Health, and Vancouver Island.
Residents have rated teaching in Geriatric Medicine among the project consists of qualitative and quantitative research studies
within VIHA that seek to understand perceptions of engagement
highest of the divisions in the Department of Medicine.
and readiness for transformative change, with an emphasis on
48
the older adult in health care systems. VIHA representatives
continue to add their expertise to the Elder Friendly Hospital
Think Tank, and published “Enhancing the Quality and Safety
Standards for Older People in Canadian Hospitals” in Healthcare
Quarterly Vol 16. No 1 2013.
Dr. Roger Wong researches acute care service delivery for older
adults, and medical education to enhance competency in quality
improvement, health advocacy, and communication among IM
residents.
Dr. Lynn Beattie is involved in multiple research projects related
to dementia. She is a co-principal investigator with the Canadian
Dementia Knowledge Translation Network, and has a CIHR grant
related to aspects of Aboriginal Health. She is a member of the
CIHR Gender, Sex and Health Committee, and Director, Centre
for Health Aging at Providence.
Dr. Amanda Hill, in collaboration with the UBC Division of
Cardiology at St. Paul’s Hospital, is studying how to improve
Geriatric Assessment of elderly pre-operative patients.
Geriatric Clinic, as well as geriatric consultation services, which
provides teaching for UBC students and residents. Geriatrics on
Vancouver Island provide a wide range of inpatient consultation
and outpatient and home visit services, and aims to expand
availability up island. Geriatricians on the North Shore also
provide inpatient consultation, outpatient services, outreach,
and leadership in complex residential care, as well as rotation
opportunities for Fellows.
Collaboration between Vancouver General Hospital and
Providence Health Care has extended the geriatric outreach
network to most of the Community Health Centers within
Vancouver Community Health and is working to strengthen
the collaboration between primary, community and acute
care. Dr. Chris Rauscher continues his work on the Frail Elderly
Collaborative project and as a “clinical quality improvement
advisor” working throughout BC with the Ministry of Health and
Vancouver Coastal Health, including the Transforming Seniors
Care Initiative.
Drs. Larry Dian, Janet Kushner-Kow and Ken Madden are part
of the Geriatrics Outreach Teams to Northern BC, providing
Geriatric Medicine and Geriatric Psychiatry consultation services
to northern, rural and remote communities including Queen
Charlotte City, Masset, Prince Rupert, Terrace, Kitimat, Smithers,
Burns Lake, Vanderhoof, Fraser Lake, McBride, Dawson Creek,
Dr. Larry Dian is co-investigator at the ProHealth Clinical
Research Center and is interested in osteoporosis and falls in the Fort St John and Fort Nelson. This unique model of care sees
frail elderly. He is a member of the Scientific Advisory Council for the specialists visiting communities on a regular basis and
working in tandem with local community service providers. Dr.
Osteoporosis Canada.
Ima Alimoradi provides a similar service to Kelowna and Interior
Health.
Dr. Diane Villanyi continues to pursue her interest in drug use
and adverse events in the elderly.
Dr. Lynn Beattie is Medical Director for the UBC Alzheimer and
Related Disorders Clinic. It is the only clinic of its kind in BC. She
Dr. Phillip Lee participates in dementia research with the
has been in this position since the clinic’s inception in 2005.
Alzheimer’s and Related Disorders clinic.
Dr. Wendy Cook is participating in an ongoing CHIR
demonstration project with PI Maureen Ashe from CHHM: B4
post hip fracture study.
Dr. Jocelyn Chase completed her fellowship research project
“Accelerometer-Based Measures of Sedentary Behavior and
Cardio-Metabolic Risk Factors in Active Community-Dwelling
Older Adults”.
CLINICAL ACTIVITIES
The ACE units and newly started SAFE unit (Specialized
Assessment of the Frail Elderly) at Vancouver General Hospital
continue to serve the elderly admitted to Acute Care. The
consult service, rapid access clinics and home visit service
are busy and are popular electives for IM residents. St. Paul’s
Hospital has an interdisciplinary Geriatric Consult and Outreach
Team for inpatient consultation and rapid access ambulatory
services. Providence Health Care also has an Integrated Care for
Elders Unit, a consultation service, and an enhanced outpatient
service at Mount St. Joseph’s Hospital. Geriatricians have also
collaborated with nursing to provide improved transitions
for patients discharged from Acute Care. They liaise with
the Emergency Nurses, and provide Rapid Access Clinic for
patients discharged from Emergency. In the rapidly expanding
Fraser Health Region, Geriatric Medicine services continue
to grow; there is an enhanced multi-disciplinary Specialized
Dr. Wendy Cook continues to develop the St. Paul’s Hospital Falls
Clinic and pursue her research interests in falls, mobility and
prevention of injuries in the elderly.
Dr. Phillip Lee continues to provide consultation in memory
disorder clinics at St. Paul’s Hospital and the Alzheimer’s and
Related Disorders Clinic at UBC Hospital.
Dr. Graydon Meneilly continues to run the only specialized
Geriatric Diabetic Clinic in Canada.
FUTURE DIRECTIONS
Development of a formal Strategic Plan for the Division of
Geriatric Medicine will await the appointment of a new
permanent Head of the Division. In the interim, the division has
established a Practice Plan to help support and encourage career
development and research opportunities for junior faculty.
The division is also developing a website to provide the
community with information on clinical services across the
province, as well as recruitment opportunities, and publicizing
the need for volunteers for ongoing research trials.
We are also working to strengthen ties with Geriatric Medicine
physicians throughout the province to increase opportunities for
49
collaboration, recruitment and teaching.
Special Honours and Awards
Dr. B. Lynn Beattie received a Queen Elizabeth II Diamond
Jubilee medal in recognition of her long standing contributions
in the field of Geriatrics.
Dr. Graydon Meneilly is B.C. Governor of the American College of
Physicians, the nation’s largest medical specialty organization.
Dr. Roger Wong is President of the Canadian Geriatrics Society.
Dr. Ken Madden continues on as the Editor in Chief of the only
academic Geriatric Medicine Journal in Canada (Canadian
Journal of Geriatrics), which was entered into PubMed for the
first time during his tenure.
Dr. Jocelyn Chase won the Dr. Jack MacDonnell prize at the 2013
Canadian Geriatric Society Conference for the best research
presentation for research completed during Geriatric Medicine
fellowship.
50
HEMATOLOGY
Division Members
Dr. Alina Gerrie (under the supervision of Dr.
Toze, Dr. Joe Connors and Dr. Tanya Gillan),
Dr. Natalia Rydz (under the supervision of Dr.
David Lillicrap) and Dr. Chris Venner (under
the supervision of Dr. Song and Dr. Jamie
Cavenagh) completed fellowships in chronic
lymphocytic leukemia (in Boston), hemophilia
(in Kingston) and myeloma (in London, UK),
respectively. Dr. Tyler Smith continued and
Dr. Erica Peterson started fellowships in
thrombosis (under the supervision of Dr. Lee).
Professor
Dr. Edward Conway
Dr. Keith Humphries
Dr. Allan Jones
Dr. Peter Lansdorp
Dr. John Schrader
Clinical Professor
Dr. Penny Ballem
Dr. Michael Barnett
Dr. Donna Hogge
Dr. Stephen Nantel
Dr. Thomas Nevill
Dr. John Shepherd
Dr. Linda Vickars
Associate Professor
Dr. Agnes Lee
Dr. Raewyn Broady
Dr. Donna Forrest
Dr. Chantal Leger
Dr. Heater Leitch
Dr. Charles Li
Dr. Kevin Song
Dr. Gayatri Sreenivasan
Dr. Heather Sutherland
Dr. Cynthia Toze
Dr. Yasser Abou Mourad
Dr. Camilla Boldt
Dr. Luke Chen
Dr. Maggie Constantine
Dr. Lynda Foltz
Dr. Shannon Jackson
Dr. Khaled Ramadan
Dr. Peter Tsang
Dr. Paul Yenson
Dr. Leslie Zypchen
Clinical Instructor
Dr. Kimberley Ambler
Dr. Hatoon Ezzat
Dr. Tanya Petraszko
Associate Member
Dr. Kate Chipperfield
Dr. Robert Coupland
Dr. Connie Eaves
Dr. Xiaoyan Jiang
Dr. Aly Karsan
Dr. Michael Barnett
Division Overview
In 2012, the UBC Division of Hematology included
38 staff and 5 associate staff members based at
the Vancouver General Hospital (VGH), St. Paul’s
Hospital (SPH), Royal Columbian Hospital (RCH),
the Terry Fox Laboratory (TFL) at the British
Columbia Cancer Research Centre (BCCRC) of the
BC Cancer Agency (BCCA) and the University of
British Columbia (UBC). The year was defined by
the early retirement of a notable member of the
Division.
In the summer, Dr. Linda Vickars was forced to
retire because of illness. Her distinguished career
as an outstanding clinician/teacher spanned
nearly three decades (1985 to 2012). Her many
accomplishments included the establishment and
development of the Division of Hematology at
SPH (Head from 1998 to 2006), having previously
been Head of the section of Hematology/Medical
Oncology (1994 to 1998), as well as the Adult
Hemophilia and Hemosiderosis Programs of BC
based at SPH (Director from 2004 to 2011) and
the Adult Hemoglobinopathy Program of BC based
at SPH (Director from 2009 to 2011).
Dr. Jackson and Dr. Ezzat became Directors of
the Hemophilia Program and Hemoglobinopathy
Program, respectively at SPH.
Dr. Camilla Boldt, who has a particular interest
and expertise in thrombosis, joined the Division at
SPH.
Dr. Kim Ambler, after a period of fellowship in
apheresis at the Mayo Clinic, Rochester and
Cancer Care Alliance, Seattle joined the General
Hematology and Apheresis Groups at VGH.
51
Drs. Shepherd (Director of the Leukemia/
BMT Program at VGH and BCCA), Dr. Nantel
(Medical Director of the Clinical Practice
Unit (CPU) for Hematology/BMT at VGH),
Dr. Tsang (Head of General Hematology at
VGH and Director of the Hematology Training
Program), Dr. Sreenivasan (Director of the
Apheresis Program at VGH), Dr. Lee (Director
of the Thrombosis Program at VGH and UBC),
Dr. Jackson (Medical Director of the Adult
Hemophilia Program at SPH), Dr. Ezzat (Medical
Director of the Adult Hemoglobinopathy and
Adult Hemosiderosis Programs at SPH) and Dr.
Barnett (Head of Hematology at UBC, VGH and
SPH) continued in leadership positions.
At VGH, the activities of the Division were
overseen by a Hematology Executive made
up of Drs. Barnett, Shepherd and Nantel. Dr.
Nantel was chairman of the Hematology/BMT
CPU committee whose membership was as
follows: Dr. Barnett, Dr. Shepherd, Dr. Tsang,
Dr. Sreenivasan, Dr. Lee, Ms. K. Hermkens
(Administrative Manager, Hematology), Ms. N.
Edge (Patient Services Manager, Hematology/
BMT), Ms. A. Bisaillon (Operations Director)
and Ms. A. MacDonald (Finance Manager).
The committee met monthly to review issues
arising and to propose new initiatives.
At SPH, interactions with the administrative
group were on an ad hoc basis. Dr. P. Man
(Head of Medicine), Dr. R. Carere (Vice
President, Medical Affairs) and Dr. Y. Lefebvre
(Vice President, Research and Academic
Affairs) gave important support to the group.
Mr. K. Harman (Leader, Medical Affairs) and
Ms. J. Victory (Program Director, Medicine/
Ambulatory) worked diligently on the group’s
behalf. Ms A. Skihar (Operations Leader,
Ambulatory Care Medical Clinics) and Ms. S.
Chutskoff (Operations Leader, 7ABCD, 8A) were
highly supportive in regard to issues related to
hematological activity on the MSSU and the
inpatient wards, respectively.
Laboratory research programs at TFL, UBC and Vancouver
Coastal Health Research Institute (VCHRI) achieved peerreviewed operating support of $3.8 million and clinical
research at VGH and SPH brought in $1.2 million. There
was a total of 61 peer-reviewed publications. Patient care
and training remained at the forefront of clinical activities.
Trainees in the Division as a whole included 12 Hematology
residents, 12 Leukemia/BMT fellows and 24 laboratory postdoctoral fellows
Teaching
Undergraduate:
Dr. Sreenivasan served as Week Chair of the Blood &
Lymphatics Problem Based Learning (PBL) block (two weeks)
for undergraduates. A number of members of the Division
participated in the PBL teaching course.
Postgraduate:
A total of 32 residents in the Internal Medicine Program took
hematology-based electives during the past year. These
were one or two month blocks spent on the Hematology
Consultation Service at VGH or SPH.
Subspecialty Training:
Dr. Tsang served as Director of the Hematology Training
Program. Twelve Hematology residents (in overlapping
academic years) were based at VGH in 2012. Rotations
included the General Hematology Consultation Service,
Leukemia/BMT Service, Blood Transfusion Service, Apheresis
Unit, Out-patient Clinics and Hematopathology. Rotations
were also taken at SPH, Vancouver Cancer Centre, BC
Women’s and Children’s Hospital. These positions were
taken by Drs. Maha Badawi, Gloria Lim, Erica Peterson, Ursula
Skalska (July, 2010-June, 2012); Walaa Rajkhan (March, 2011);
Michael Szeto and Katharine Xing (July, 2011); Mohamed
Abuhaleeqa, Mousa Al Zahrani, Gagan Kaila, Kai Luecke and
Linda Sun (July, 2012).
Dr. Forrest served as Director of the Leukemia/BMT Training
Program. Fellowship positions were available for clinical
training in the management of patients with hematological
malignancies and those undergoing hematopoietic stem cell
transplantation. These positions were taken by Drs. Kannadit
Prayongratana (September, 2010-August, 2012); Nitin Gupta
(April, 2011-June, 2012); Adam Bryant (May, 2011-May, 2012);
Subhaprakash Sanyal and Chandrakala Shanmukhaiah (July,
2011-June, 2012); Sachin Jadhav (September, 2011-August,
2012); Krystal Bergin and Emma Palfreyman (March, 2012);
Bridgett McDiarmid (April, 2012); Alina Gerrie (July-December,
2012); Mallikarjun Kalashetty and Ganesh Jaishetwar (October,
2012).
Postdoctoral Training:
Division Members conducting bench research at the TFL and
UBC trained 24 postdoctoral fellows, 19 of whom were PhDs.
Doctoral Training:
The TFL accommodated 17 graduate students as well as 17
52
research and co-op students.
Members of the Division organized the following series of
meetings in 2012: BC Chronic Lymphocytic Leukemia Day
(Dr. Toze) in February; 1st Norman Bethune Symposium
on Transfusion Medicine (Dr. Conway) in March; Earl Davie
Symposium on Hemostasis and Thrombosis (Dr. Conway) in
November.
Research
Clinical research involved hematological malignancies,
hematopoietic stem cell transplantation, apheresis, blood
product support, thrombosis, bleeding disorders, iron
overload and HIV/AIDS. As well as in-house studies, significant
contributions were made to national and international trials.
In addition, a number of important observational studies were
conducted and reported on.
A Thrombosis Research Program, including collaboration
with Dr. Conway and other investigators at the Centre for
Blood Research at UBC, is being developed by Dr. Lee. A
similar undertaking by Dr. Jackson, Dr. John Wu (BC Children’s
Hospital) and Dr. Conway for the development of an Inherited
Bleeding Disorder Research Program has resulted in the
establishment of the UBC Bleeding Disorders Collaboratory. In
an ongoing collaboration between the Leukemia/BMT group
and the Blood Transfusion Services at VGH, Dr. Chipperfield
leads a trial to evaluate the outcome of platelet transfusion.
In a new initiative with the Genome Sciences Centre (BCCA),
Dr. Hogge and Dr. Karsan are investigating the application of
genomics to the management of acute myeloid leukemia and
myelodysplasia.
From early 2005, a major initiative has been the development
of the Hematology Research and Clinical Trials Unit (HRCTU),
which has been made possible by substantial initial and
ongoing support from donors as well as a grant from the
Ministry of Health Services, BC in 2008. The goals of the
HRCTU are: to produce and evaluate new treatments (more
effective and less toxic) for blood diseases; to provide British
Columbians with access to new treatments much earlier that
would otherwise be possible; to improve quality of life for
patients with blood diseases. In 2006, the HRCTU became the
study centre (led by Dr. Toze, former Director of the Leukemia/
BMT Program Dr. Clay Smith and Coordinator Holly Kerr) for
a major Canadian trial (Principal Investigator Dr. Kirk Schultz,
BC Children’s Hospital) of the Canadian Blood and Marrow
Transplant Group. The trial (funded by the National Institutes
of Health, USA) became international in 2008 when transplant
groups in Australia, New Zealand, Saudi Arabia and the USA
were recruited. Accrual was complete by January 2012 and
the intention is to present the results at the American Society
of Hematology annual meeting in December 2013. In parallel
with the HRCTU, a Hematology Cell Bank (HCB) was developed
in 2005. The HCB collects and stores specimens of blood and
marrow (for research) from patients and donors.
Important research related to the value of iron chelation
therapy in patients with myelodyspasia and myelofibrosis is
being conducted by Dr. Leitch and has gained international
recognition.
Laboratory research based at the TFL (Drs. Eaves, Hogge,
Humphries, Jiang, Karsan and Lansdorp) involved the cellular
and molecular characterization of normal and malignant
hematopoietic cell growth and differentiation with special
emphasis on the myeloid leukemias, myelodysplasia,
microRNAs, Hox genes and telomeres. Cytokines (GM-CSF),
antibodies (human monoclonal) and vaccines (influenza)
were at the forefront of research at the Biomedical Research
Centre, UBC (Dr. Schrader). The interplay between the
coagulation and the complement systems was the focus at
the Centre for Blood Research, UBC (Dr. Conway). Research
related to graft versus host disease and graft tolerance was
conducted at the Children & Family Research Institute (Dr.
Broady).
Clinical Services
The Leukemia/BMT group at VGH/BCCA had 13 members: Drs.
Shepherd (Director), Barnett, Hogge, Sutherland (on sabbatical
leave February-July), Nantel, Toze (on sabbatical leave from
October), Nevill, Forrest, Song, Broady, Abou Mourad, Power
and Narayanan. The group provided comprehensive inpatient
(T15 Ward) and outpatient (Krall Centre, Centennial Pavilion)
care to patients with hematological malignancies and those
undergoing hematopoietic stem cell transplantation. Marrow
Failure (Drs. Nevill, Hogge, Power and Narayanan) and Graft
Versus Host Disease (Drs. Nevill and Broady) clinics were
held weekly. Outreach clinics in Abbotsford, Kelowna, Prince
George and Victoria were held monthly.
The General Hematology group at VGH had 8 members: Drs.
Tsang (Head), Li, Sreenivasan, Zypchen , Lee, Yenson, Chen
and Ambler. The group was responsible for the Hematology
Consultation Service at VGH. The number of consultations
has increased steadily over the past 5 years. In addition,
the patient population includes those with complex medical
and surgical problems. Each member also had outpatient
clinics. A Thrombosis clinic was held daily, 5 days per week.
Three of the group, Drs. Tsang, Li and Zypchen provided a
consultation service and call coverage for the B.C. Women’s
Hospital (BCWH). They held a weekly outpatient Hematology
clinic at BCWH which included teaching of trainees from
Medicine, Hematology and Obstetrics. Four of the group,
Drs. Sreenivasan (Director), Zypchen, Yenson and Ambler
had a cross appointment with the Apheresis Unit (under a
Clinical Services Contract). A significant challenge for the
General Hematology group at VGH relates to remuneration
and resources. Payment for clinical work is on a fee for service
basis. From a number of perspectives, an alternate payment
plan (APP) would be more appropriate. In this regard, in
November 2011, the Division, led by Dr. Tsang, entered
discussions with Physician Relations and Compensation
regarding the possibility of an FTE structure for General
Hematology at VGH and corresponding APP application to the
Ministry of Health. This initiative is ongoing.
The Division of Hematology at SPH had 8 clinicians: Drs.
Vickars (on medical leave), Leger, Leitch, Ramadan, Foltz,
Jackson, Ezzat and Boldt. The group was responsible for the
care of patients with a complete spectrum of hematological
disease both benign and malignant, including acute leukemia
and aggressive lymphoma (some HIV-associated). The
workload was demanding. Primary and consultative care for
inpatients at SPH was provided on a rotational (weekly) basis.
Daycare activity was carried out on the Medical Short Stay
Unit (MSSU) at SPH. Outpatient clinics were conducted in a
facility across from SPH on Burrard Street. Weekly Hemophilia
and Hemoglobinopathy clinics were run by Dr. Jackson and
Dr. Ezzat, respectively. Dr. Jackson held Hemophilia Outreach
clinics in Kelowna, Prince George and Victoria (with addition
of Nanaimo planned for 2013). Drs. Leger and Leitch saw
patients with HIV/AIDS related hematological disorders in
their clinics. The group received remuneration from a Clinical
Services Contract as well as sessional funds for Hemophilia,
Hemoglobinopathy and Hemosiderosis clinics. By far the
major problem for the group at SPH is, with the exception
of the Hemophilia, Hemoglobinopathy and Hemosiderosis
Programs, lack of infrastructure support. Drs. Jackson
and Ezzat are members of an Inherited Bleeding & Red
Cell Disorders Strategic Advisory Group (SAG) within the
Provincial Blood Coordinating Office (PBCO; Medical Director
Dr. Petraszko) In regard to hematological oncology, in June
2011, with the support of Dr. R. Carere (PHC) and Dr. C. Blanke
(BCCA), an external review of activity at SPH was carried
out. The report from this review became available in early
2012. Since then, Dr. Foltz has formed a working group with
representatives from Nursing and Pharmacy on the inpatient
ward and MSSU to address the issues raised by the review.
In addition, discussions with BCCA and PHC were initiated in
regard to appropriate funding (staffing and infrastructure) for
hematological oncology at SPH.
Future Directions
The infusion of new blood in the form of key recruits over the
last 3 to 5 years has allowed the Division to create a broad and
strong platform from which to pursue future directions. It is
intended that the major initiatives over the next 5 years will
be to:
• Develop a comprehensive Thrombosis Program
• Develop a comprehensive Inherited Bleeding Disorder
Program
• Develop a comprehensive Hemoglobinopathy Program
• Sustain the Hematology Research and Clinical Trials Unit
• Enhance translational research in hematological
malignancy and stem cell transplantation
• Promote collaborations with the Centre for Blood
Research
• Create fellowships in a range of hematological fields
• Determine the provincial need for Hematology Services
Special Honours and Awards
Dr. Agnes Lee
Served as co-chair of the American Society of Hematology
Education Program
53
Dr. Tom Nevill
Completed a two year term as President of the Canadian
Hematology Society (2010-11)
Dr. Charles Li
Became Chair of the Department of Medicine Clinical Faculty
Affairs Committee
Dr. Hatoon Ezzat
Was awarded MSc in Hemoglobinopathy (University College
London, UK and the International Thalassaemia Federation)
54
INFECTIOUS DISEASES
Division Members
Professor
Dr. Yossef Av-Gay
Dr. William Bowie
Dr. Robert Brunham
Dr. Anthony Chow (Emeritus)
Dr. Neil Reiner
Dr. Grant Stiver (Emeritus)
Clinical Professor
Dr. Robert Chan (Emeritus)
Dr. Peter Phillips
Associate Professor
Dr. Zakaria Hmama
Dr. Theodore Steiner
Dr. Valentina Montessori
Dr. Neora Pick
Dr. Natasha Press
Dr. Peter Phillips
Assistant Professor
Dr. Melanie Murray (Partner)
Dr. Devki Nandan
Dr. Richard Lester
Dr. Robert Reynolds
Adjunct Professor
Dr. Horacio Bach
Associate Member
Dr. Yasmin Arikan
Dr. Michael Chapman
Dr. Wayne Ghesquiere
Dr. Jennifer Grant
Dr. Jan Hajek
Dr. Mark Hull
Dr. Victor Leung
Dr. Sangita Malhotra
Dr. Janet McElhaney
Dr. Robert McMaster
Dr. Yazdan Mirzanejad
Dr. Deborah Money
Dr. David Patrick
Dr. Laurenna Peters
Dr. Michael Rekart
Dr. Steven Reynolds
Dr. Christopher Wong
Division Overview
Administration
Infectious Diseases active faculty increased in size
in 2012 to include 16 clinicians, clinical scientists,
full time research faculty, another 17 associate
members, and 3 emeritus faculty. Activities have
been focused at the three teaching hospitals;
Vancouver General (VGH), St. Paul’s (SPH), and
BC Children’s & Women’s Hospitals, (BCCWH) and
at the BC Centre for Disease Control (BCCDC). Dr
Mary Kestler is the newest faculty member joining
PHSA/BC Women’s Hospital at the Oaktree Clinic.
Education
Undergraduate:
Dr Bill Bowie, as the Undergraduate Education Supervisor for the Division of Infectious Diseases has
been involved with ongoing curriculum changes.
Basic science training in the Immunity and Infection Research laboratories at VGH also continues
to attract outstanding students. A number of faculty teach undergraduate microbiology to science
students as well as supervise co-op and directed
studies students in their labs.
Postgraduate:
Residency Training Program Director, Dr Natasha
Press, along with Medical Education Coordinator,
Kirstie Lang, coordinated inpatient and outpatient
training for 61 residents from a range of UBC
medical and surgical programs at St. Paul’s (SPH)
and Vancouver General Hospitals (VGH). Increases
in the number of trainees from other Canadian
medical schools continued this year with 22 students and residents) visiting UBC for elective training in ID this year. Training opportunities include
55
both inpatient and outpatient core rotations,
and electives in general Infectious Diseases as
well as HIV/AIDS (Immunodeficiency Clinic and
the St. Paul’s Hospital AIDS ward). A structured series of twelve 1 hour didactic sessions
for each 4 week training block, Combined
Structured Teaching (CST) Rounds, has been
implemented for residents and students on
ID rotation at SPH and VGH using teleconferencing. This curriculum provides an overview
of common infectious disease syndromes,
medical microbiology, infection control, and
antimicrobial stewardship. Regular testing
of core internal medicine residents during
their ID rotation has been initiated using the
Medical Knowledge Self Assessment Program
(MKSAP). The Subspecialty Training Program
continues to attract exceptionally qualified
and talented applicants who go on to successfully complete the two year training program.
This year the trainees included 5 Fellows in
Infectious Diseases. Ngan Nguyen completed
her ID training with two significant fellowship
awards, a Post Residency Fellowship sponsored
by AMMI (Association of Medical Microbiology
and Infectious Diseases) and Pfizer as well as
the coveted UBC Clinician Investigator Program award. This will enable her to develop
her research skills in basic and translational
immunology.
Graduate Students: Division members at
various locations supervised Masters and PhD
science students affiliated with Experimental Medicine, Health Care and Epidemiology,
Laboratory Medicine, Microbiology and Immunology, and Medical Genetics.
Research
Research programs being conducted at all four
principal sites of the Division are diverse and
broad-based as detailed below. The Division’s
research programs are highly productive and
innovative.
Host defense and pathogenesis: The Division
maintains an active basic research program in
molecular microbial pathogenesis and host defense at VGH. Pathogens under study include
M. tuberculosis, nontuberculous mycobacteria, Leishmania, E. coli, and Chlamydia. In
addition to addressing mechanisms of pathogenesis, ongoing research is concerned with
both innate and acquired immune responses
to infection, including vaccine development.
There is also active collaborative research on
the fundamental pathogenesis and novel treatments for inflammatory bowel disease.
From auto-immune disorders that lead to
diabetes, to preventing rejection in organ
transplantation, the Immunity & Infection Research Centre
team, led by Dr. Neil Reiner, works to understand the immune
mechanisms that both fight infectious diseases and cause immune disorders. Faculty members involved in these research
programs include Drs. Av-Gay, Bach, Brunham, Hmama, Lester,
McMaster, Reiner, Stiver, and Steiner.
HIV/AIDS Research: The AIDS Research Program is conducted
through the BC Centre for Excellence in HIV/AIDS at the St.
Paul’s site, and the Oak Tree Clinic at BCCWH. It is nationally
and internationally recognized for work in all facets of HIV,
including behavioral studies, epidemiology, clinical trials and
basic sciences. A number of ID faculty (Drs. Montessori, Press,
Phillips, Hull, Pick and Murray) are involved in clinical research
activities related to the AIDS Research Program including
endocrinopathy in HIV/AIDS, trends in HIV-related hospitalizations, and HIV co-infections such as hepatitis C and human
papillomavirus.
Epidemiological Research: The wide ranging research of ID
Faculty at the UBC CDC (Drs Lester, Patrick and Brunham) includes sexually transmitted infection (STI) prevention; control
and service delivery; control of emerging infectious diseases;
assessment of human papillomavirus infection (HPV); reduction of antimicrobial misuse as linked to the emergence of
resistant organisms; detection and description of unique outbreaks such as Cryptococcus gattii disease; and early interruption of transmission of diseases from infected food products.
Clinical and Translational Research: Division members are
involved in both industry sponsored and investigator-initiated
studies that recruit volunteers to study new anti-infective
treatment strategies. Recent observational studies have also
included immune reconstitution inflammatory syndromes.
Dr. Rich Lester has initiated a research program to study the
use of mobile devices to support medical practice and public
health (“mhealth”). Specific studies involve the use of a short
message service (SMS texting) in order to provide support
and improve adherence in the management of HIV/AIDS (The
WelTel Retain Trial), pre-exposure HIV prophylaxis (PREP),
and latent tuberculosis infection (LTBI). The CIHR and Public
Health Agency of Canada Influenza Research Network (PCIRN)
study, directed by Grant Stiver for the UBC centre, follows severe outcomes surveillance and health care workers vaccination side effects at VGH. Dr. Steiner has an active translational
research project examining pathological T cell responses in
Crohn’s disease in collaboration with members of the Division of GI and the Department of Surgery, as well as several
clinical trials on new treatments and prevention of Clostridium
difficile infection. A review of the clinical spectrum of disease
and long-term outcomes in Cryptococcus gattii infection in BC
is being completed (Dr. Phillips and co-investigators at BCCDC).
ing demand to treat infections in reconstructive, trauma,
and spine orthopedics, neurosurgery, bone marrow and solid
organ transplant, and tuberculosis. The ID staff also initiates
and supervises treatment of patients in the home IV antibiotic
program at both sites, which is critical for the timely discharge
of patients from inpatient units. The SPH group has a special
interest and competency with the treatment of infections
related to cardiovascular disease and interventions, HIV/AIDS,
injection drug use, and infections in marginalized populations.
The Anal Dysplasia Clinic (human papillomavirus) at SPH is a
provincial resource under the direction of Dr. Press. The AIDS
ward based at SPH is a unique Canadian facility (since 1997)
which provides care for 20 inpatients with various HIV-related
diseases. Dr. David Patrick is leading the development of the
PHSA supported Chronic Complex Disease Clinic which will address both clinical service and research needs of patients with
chronic fatigue syndrome/ myalgic encephalomyelitis, possible
or proven Lyme disease, and systemic lupus erythematosis.
This multidisciplinary clinic is expected to begin seeing patients later this year and will be based at BC Women’s Hospital. Finally, the ID group, along with Medical Microbiology
and Pharmacy, has begun antibiotic stewardship programs to
guide evidence-based and cost-effective use of antimicrobial
drugs in inpatients at VGH and SPH.
Future Directions
Development of a Transplant Infectious Diseases Program is a
high priority for the Division. It is anticipated that a Transplant
ID clinical service will be initiated in 2014 in order to provide
optimal patient care and foster clinical research, complementing the existing basic science organ transplant research
program. Another Divisional goal is the recruitment of a
Global Health clinician-scientist, for whom a formal search has
recently been initiated. Vancouver’s size, multicultural population, and location as “gateway to the pacific rim” support this
initiative, which would complement existing UBC research
programs in global health diseases, in addition to addressing
clinical service needs, both locally and internationally.
Clinical Services
The Division maintains two very active inpatient consultation services at SPH and at VGH. The trend of increasing
complexity, greater numbers of consultations (7% growth per
year at VGH), and the ongoing effect of antibiotic resistance,
make the ID clinical programs dynamic and challenging to
administer. In addition to general ID cases, there is increasUBC DEPARTMENT OF MEDICINE - ANNUAL REPORT 2012
56
MEDICAL ONCOLOGY
Division Members
Professor
Dr. Charles Blanke
Dr. Max Coppes
Dr. Karen Gelman
Clinical Professor
Dr. Joseph Connors
Dr. Paul Hoskins
Dr. Richard Klasa
Dr. Grant MacLean
Dr. Nevin Murray
Dr. Amil Shah
Dr. Brian Weinerman
Dr. Kenneth Wilson
(Clinical Instructor - continued)
Dr. Mary MacNeil
Dr. Heidi Martins
Dr. John McGhie
Dr. Judith Sutherland
Dr. Ann Tan
Dr. Tamana Walia
Dr. Tamana Walia
Associate Professor
Dr. Kim Chi
Dr. Sharlene Gill
Dr. Kerry Savage
Dr. Christopher Coppin
Dr. Hagen Kennecke
Dr. Christian Kollmannsberger
Dr. Barb Melosky
Dr. Laurie Sehn
Dr. Tamara Shenkier
Assistant Professor
Dr. Winson Cheung
Dr. Daniel Renouf
Dr. Sharon Allan
Dr. Abdul Al-Tourah
Dr. Helen Anderson
Dr. Andrew Attwell
Dr. Vanessa Bernstein
Dr. Ashley Davidson
Dr. Janine Davies
Dr. Thuan Do
Dr. Greg Dueck
Dr. Susan Ellard
Dr. Catherine itzgerald
Dr. Eric Fretz
Dr. Paul Galbraith
Dr. Karamjit Gill
Dr. Anagha Gurjal
Dr. Jason Hart
Dr. Cheryl Ho
Dr. Bruce Keith
Dr. Kong Khoo
Dr. Margaret Knowling
Dr. Janessa Laskin
Dr. Lyly Le
Dr. Ursula Lee
Dr. Chris Lee
Dr. Howard Lim
Dr. Caroline Lohrisch
Dr. Nicol Macpherson
Dr. Lee Ann Martin
Dr. Jorg Michels
Dr. Deepu Mirchandani
Dr. R. Michael C. Noble
Dr. Gary Pansegrau
Dr. Sanjay Rao
Dr. Delia Sauciuc
Dr. Ravi Sawhney
Dr. Sheila Souliere
Dr. Sophie Sun
Dr. Marianne Taylor
Dr. Sara Taylor
Dr. Anna Tinker
Dr. Dorothy Uhlman
Dr. Robert Winston
Dr. Adrian Yee
Dr. John Yun
Dr. Muhammad Zulfiqar
Clinical Instructor
Dr. Theresa Chan
Dr. Daygen Finch
Dr. Balvindar Johal
Dr. Doran Ksienski
57
Dr. Charles Blanke
Professor and Head
Overview
The Division of Medical Oncology, UBC
Department of Medicine, comprises staff at
the British Columbia Cancer Agency, including
the Vancouver, Fraser Valley, Abbottsford, and
Vancouver Island Cancer Centres, and the Centres
for the North and Southern Interior. The sixth
regional centre (in the North) formally opened
in Prince George in 2012. In addition to the
clinical division, there is a laboratory section
(Experimental Therapeutics), comprising senior
scientists and clinical investigators who have
appointments at the Vancouver Cancer Center,
Department of Medical Oncology, and which is
located in the British Columbia Cancer Research
Center, Vancouver. Medical Oncology clinical
services are organized as a Provincial Systemic
Therapy Program reaching across the Province.
Vancouver Cancer Centre has its own inpatient
unit, while also utilizing beds at the Vancouver
General Hospital. The regional centres are
affiliated with a variety of local hospitals.
Teaching
Undergraduate teaching occurs in the Vancouver,
Victoria, Fraser Valley, and Kelowna Cancer
centres. Postgraduate teaching occurs
primarily at the Vancouver Cancer Centre,
with additional elective opportunities
available at all five active cancer centres. UBC
clinical faculty at all centres participate in
undergraduate and/or resident teaching.
The Medical Oncology Undergraduate Training
Committee, led by Drs. Howard Lim and
Winson Cheung, introduces an introduction
to neoplasia via the Principles of Human
Biology course, part of the undergraduate
MD program. It also coordinates clinical
skills teaching, including the history-physical
examination sessions in Internal Medicine.
Members of the staff conduct the Academic
Half-Day sessions in Medical Oncology during
the Internal Medicine clerkship in third
year and participate in scheduled bedside
teaching. An elective in Medical Oncology is
available to UBC and visiting medical students.
Additionally, since the opening of the Island
Medical Program, most 3rd year medical
students have spent part of their internal
medicine rotation learning medical oncology at
the Vancouver Island Cancer Centre.
Dr. Tamara Shenkier is the Postgraduate
Training Program Director. With the help of
the Residency Training Program Committee,
she plans and supervises the two year
subspecialty-training program in Medical
Oncology. This program is based at the
Vancouver Cancer Centre, with opportunities
for core training available at other regional
centres by request. There are five blocks of
elective time available in the second year of
training which can be applied to community
oncology practice, clinical or translational
research or other relevant academic pursuits
nationally or internationally. Residents are
expected to conduct clinical research and
have been quite successful in publishing
and presenting at national and international
meetings. Over half of the residents compete
successfully for post-residency academic
subspecialty fellowships. The program, now
one of the largest such in Canada, enrolls
four to five residents per year and is fully
accredited by the Royal College of Physicians
and Surgeons of Canada. The Vancouver
Cancer Centre also accepts two to five national
and international Fellows per year for further
subspecialty training and research.
The Medical Oncology Residency Training
Program also offers four and eight week
electives for postgraduate trainees from UBC and other
Canadian universities. In this academic year Medical Oncology
accommodated approximately 50 internal medicine residents;
40 from UBC and eight and from other universities. In
addition some15-20 residents from other specialty disciplines
spend elective periods at the Vancouver Cancer Centre. The
Fraser Valley Cancer Centre trains an additional four to eight
postgraduate residents per academic year. Opportunities are
available for electives at the other regional cancer centres as
well.
Medical Oncology faculty are very committed to active
participation in community outreach/education programs
and to the education of health care professionals around
British Columbia. Many regularly lecture to family physicians,
community oncologists, cancer nurses and pharmacists,
both locally and at the various community oncology centres
throughout BC. Faculty have organized and conducted
multiple oncology conferences, including the Western
Canada Lung Cancer conference, the West Coast Colorectal
Cancer Conference, and a recent two day Island Oncology
Conference. The BCCA Annual Cancer Conference is highly
regarded by medical personnel from across the Province.
Members have become quite active in the American Society
of Clinical Oncology, participating on its Education Committee
and being invited to speak at the annual program and subspecialty meetings. Others are active in educational efforts
of the American Society of Hematology and the American
Association for Cancer Research.
Research
Conducting innovative research is integral to the Medical
Oncology mission. The B.C. Cancer Research Center has been
quite instrumental in furthering this effort. It encompasses
a wide range of laboratory research programs including
molecular oncology, hematologic cellular biology and
leukemias, and core programs in genomic analysis, gene
expression profiling, novel imaging and tumor modeling
and population based epidemiology and biostatics. The B.C.
Cancer Agency Genome Sciences Centre continues to forge
collaborative projects with several tumor groups within
Medical Oncology, including breast cancer, gastrointestinal
cancers, and lymphoproliferative neoplasms.
Members of the Division are involved in a wide variety
of phase I, II, III and IV clinical trials. These include the
development of new anti-cancer drugs, the evaluation of
new schedules and combinations of drugs in the phase II
and III settings, and additional design of and participation in
multi-institutional phase III studies and post-marketing phase
IV trials, evaluating effective new treatments on specific
categories of malignancy. Significant numbers have published
and presented in first-tier journals and international oncology
meetings. The Vancouver Island PREDICT (Personal Response
Determinants in Cancer Therapy) project remains a unique
example of one such effort. Newly referred cancer patients
who have not received chemotherapy or radiotherapy in the
past 5 years are essentially all approached to donate a sample
(10 cc) of blood to be stored for future research projects.
This resource has now been used for a wide-variety of REBapproved research initiated in B.C and across Canada.
Medical Oncology also has an extensive population-based
research program, primarily in the areas of breast, GI and
gynecological malignancies and lymphoma outcomes. Recent
initiatives to collect archival tumor tissue samples and
correlating biomarker status with population based outcomes
and have led to highly successful research collaborations and
publications.
The next few years pose exciting challenges and opportunities.
Medical oncologists and hematologists have increasingly been
using biologic, targeted therapies. University faculty have
made significant advances toward achieving the age of truly
individualized therapy for cancer.
Clinical Services and Administration
Medical Oncology is chaired by Charles D. Blanke, M.D.,
F.A.C.P., F.R.C.P.C. Each centre also has a regional leader for
systemic therapy. The five B.C. Cancer Centres now provide
medical oncology consultations for almost 12,000 new
patients annually, with more than 81,000 ambulatory care
visits to these institutions. The Provincial Systemic Therapy
Program, headed by Dr. Charles Blanke and aided by Dr. Susan
O’Reilly, manages the $174,000,000 provincial oncology drug
budget, which supports the care of patients both within
BCCA centres and in community hospitals. Medical Oncology
is poised to further develop a program of “world-class care
closer to home” utilizing modern telehealth equipment.
Future Directions
The major academic goal of the Division is to continue to
build upon translational and population research successes,
utilizing the excellent basic science capabilities at the British
Columbia Research Centre, input from the Genome Science
Centre, efforts of the academic medical oncologists, and the
participation of our diverse patient population.
British Columbia has again recently demonstrated top-ranked
cancer survival statistics in Canada for a number of solid
tumours, and Medical Oncology plans to continue to carry out
outstanding quality province-wide treatment programs. We
strive for continuous improvement in both the research and
service arenas.
NEPHROLOGY
Division Members
Professor
Dr. Paul Keown
Dr. Adeera Levin
Professor Emeritus
Dr. Eugene C. Cameron
Dr. John Price
Dr. Gary Quamme
Dr. Roger Sutton
Dr. Norman Wong
Clinical Professor
Dr. David Landsberg
Dr. Jean Shapiro
Dr. Paul Taylor
Dr. Ron Werb
Dr. Kit Yeung
Dr. Clifford Chan-Yan
Dr. Angus Rae
Associate Professor
Dr. John Gill
Dr. Michael Copland
Dr. John Duncan
Dr. Jacek Jastrzebski
Dr. Mercedeh Kiaii
Assistant Professor
Dr. Jagbir Gill
Dr. Monica Beaulieu
Dr. Anthony Chiu
Dr. Linda De Luca
Dr. Myriam Farah
Dr. Abeed Jamal
Dr. Olwyn Johnston
Dr. Beverly Jung
Dr. Peter Neufeld
Dr. Suneet Singh
Dr. Nadia Zalunardo
Clinical Instructor
Dr. David Prchal
Associate Members
Dr. Melanie Brown
Dr. Gerardo Carpenito
Dr. Aaron Cass
Dr. Victor Chan
Dr. Elliott Chum
Dr. Joslyn Conley
Dr. Charles Constantine
Dr. Gerald Da Roza
Dr. Brian Forzley
Dr. Gaylene Hargrove
Dr. Kevin Horgan
Dr. Christopher Jones
Dr. Mohamud Karim
Dr. George Lam
Dr. Marie Michaud
Dr. Daniel Schwartz
Dr. Robert Starko
Dr. Shirley Torng
Dr. Shaoyee Yao
Dr. Chi Zhang
Dr. Adeera Levin
Professor and Head
Overview
The UBC Division of Nephrology has a total of
51 members, which includes 24 full members,
7 emeritus and 20 associate members located
around the province. The two downtown sites
are St. Paul’s Hospital and Vancouver General
Hospital, while the Royal Columbian Hospital,
Surrey Memorial, and Abbotsford in the Fraser
Health Authority, as well as Interior Health,
Northern Health and Vancouver Island Health
authorities all participate in divisional activities.
This distributed model of education, clinical care
and research within the province is unique and
offers ever increasing potential for sustainability
and dissemination. Together the faculty provides
provincial leadership in research, education, and
clinical care within the field of renal medicine.
The 24 members of the downtown campuses
of the Division have a strong clinical base and
provide integrated and decentralized nephrology
care throughout Vancouver Coastal Health,
including Richmond, North Vancouver and coastal
areas, and as far north as the Yukon Territory, with
a strong working collaboration with Fraser Health,
VIHA, IHA and NHA. Fraser Health has established
strong links with the Internal Medicine program
and Division of Nephrology programs so that
exposure to clinicians and teachers are available.
The Division has an important role in the UBC
undergraduate medical curriculum, has a mature
nephrology postgraduate training program, and
participates in the Experimental Medicine and
Clinical Investigator programs of the Department
of Medicine. An expanding international and
59
post doctoral fellowship in home based
therapies, transplantation, dialysis and health
administration were added in 2011, and
continue as an important focus. Research
activities encompass both laboratory and
clinical sciences, with a strong focus on
epidemiology and clinical trials, and population
health and outcomes/economic investigations
in both kidney disease and transplantation.
Members of the Division assume leadership
roles in the advancement of nephrology at
provincial, national and international levels
through their positions in the BC Provincial
Renal Agency, BC Transplant, the Regional
Renal Programs, the Kidney Foundation of
Canada, the Canadian Society of Nephrology,
the Canadian Society of Transplantation, The
Transplantation Society and International
Society of Nephrology.
Administrative support for the program is
managed by Ms Lori Clements (Divisional
Administrator), Ms Tammie Davis
(Postgraduate Education), and Ms Pam Sewell
(CME Activities). Strong Partnerships with
the BC Provincial Renal Agency has permitted
leveraging of resources to support province
wide education and research activities to
various degrees.
The divisional heads in 2012 at specific sites
include: Dr Jacek Jastrzebski at VGH, Dr
David Landsberg at PHC, Dr Gerald Da Roza
at RCH, Dr John Antonsen at VIHA. The other
health authorities (IHA and NHA) do not have
Divisional heads per se, but do have medical
directors (Dr Marie Michaud and Dr. Malcolm
Ogborn), who fulfill aspects of the role.
The UBC Division of Nephrology is a key
component of the tertiary education program
for medicine and related health sciences for
the University of British Columbia. Through its
active undergraduate, graduate, post-graduate
and continuing medical education programs,
the Division is responsible for the training of
medical students, interns, residents, subspecialty residents in nephrology (SSRNs),
rotating trainees in general medicine,
anesthesia and other relevant disciplines,
graduate and doctoral students, and clinical
and research fellows. These programs attract
trainees from across Canada, and from
Australia, Europe, Asia and the Middle East.
The primary sites for undergraduate and
graduate training are at VGH SPH/Providence
Healthcare and Fraser Health Authority, with
elective opportunities available in other
jurisdictions.
Funding for the educational programs of the Division is
provided by UBC, and in collaboration with the BCPRA.
Education in pharmacy and allied health disciplines occurs
in the same sites under the auspices of UBC and related
professional bodies. In 2012, Divisional program directors
included Dr. Suneet Singh (Undergraduate Programs), Dr.
Peter Neufeld (Postgraduate Programs), Dr. Adeera Levin
(Continuing Medical Education), and Dr. Olwyn Johnston
(Transplant Fellowship Program). Dr Gerald Da Roza has
responsibility for educational programs in Internal medicine
and Nephrology in FHA. Extended training in Provincial Home
Therapies programs were offered for the first time in 2012,
under the direction of Dr Michael Copland and Dr Paul Taylor
(provincial directors of Innovative Hemodialysis and Peritoneal
Dialysis respectively). Trainees from UK and Thailand were
enrolled in the program.
Research
The Division has a strong and internationally-recognized
translational research program in both renal disease and
transplantation. Members of the Division were successfully
awarded and held over $3 million in research support in 2012,
including grants from Genome Canada, Networks of Centres
of Excellence, the CIHR, the Kidney Foundation of Canada, and
other peer-review agencies, as well as unrestricted industry
supported grants, and conventional industry supported trials.
Members of the Division generated more than 43 scientific
articles in 2012, notably some in high to very high impact
journals. Key areas of focus are: health outcomes research,
epidemiology, biomarker prediction of clinical events in
CKD and transplant populations; resource utilization, and
knowledge translation activities.
The UBC Division of Nephrology Research programs integrate
members from the VGH and SPH / Providence Health sites
as well as our associate sites around the province, to ensure
full participation and collaboration. The Division’s clinical
research activities also include collaborations with research
staff at the BC Provincial Renal agency and the iCapture Centre
at St. Paul’s Hospital, as well as research groups outside of
BC, including the Alberta Kidney Disease Network, CORR,
Canadian Transplant Clinical Trials Group, Australian Clinical
Trials Group amongst others. Divisional resources for research
leverage existing infrastructures, and situated at different
physical locations. Staff includes a Research Manager, Ms. Katy
Vela, and a number of highly-qualified Research Coordinators.
The statistical support team includes dedicated staff time
from BCPRA, under the leadership of Ms. Ogjnenka Djurdjev,
and includes Lee Er, Alexandra Romann, Gabriella Espina
and a group of data analysts. Caren Rose, a biostatistician, is
pursuing further academic work in Clinical epidemiology and
was awarded a KRESCENT fellowship in 2009, which will be
completed in 2013, after a 1 year hiatus during which she was
on maternity leave.
Clinical Activities
The renal services provided by the Division of Nephrology
operate within a broad provincial and regional context
with established clinical guidelines, provincial contracts,
information systems, central administration and co-ordination
for education and other projects. This affords the Division an
opportunity to be both a key contributor to and a beneficiary
of provincial policies, projects and experience. British
Columbia is widely recognized to be at the forefront of renal
care delivery, with active programs for the early detection of
renal disease in the population, multidisciplinary coordination
of care, delivery of dialysis therapy in the community or at
home, and novel approaches to renal transplant donation.
The BC Provincial Renal Agency (BCPRA) coordinates the
development and integration of renal services, funding,
establishment of standards and guidelines, and works in
collaboration with each of the health authorities to ensure
equal access to care for all patients living with kidney disease.
The BC Transplant Society coordinates the funding and
oversight of renal and other solid organ transplant services
and the retrieval of cadaveric organs and tissues.
Within this framework, renal care delivery is based on
established principles of integrated chronic disease
management through a combination of institutional,
community and home-based programs. The tertiary care
teaching hospitals, the Vancouver General Hospital (VGH), St.
Paul’s Hospital (SPH Providence Healthcare) and BC Children’s
Hospital (BCCH), collaborate to provide ambulatory chronic
renal disease care, in-patient management, plasma exchange
(SPH), hospital dialysis and renal transplantation, and home
hemo and peritoneal dialysis for adult and pediatric patients
with renal disease throughout the Vancouver Coastal Health
and other geographical jurisdictions. The home hemodialysis
program, headed by Dr. Michael Copland, is now one of
the largest of its kind in North America. Novel approaches
to education and delivery of newer modalities is a focus
for the division province wide. Within the province of BC,
2500 persons receive dialysis, 2,000 persons have received
a transplant and over 10,000 persons have chronic kidney
disease and are followed by nephrologists.
NEUROLOGY
Milnerwood as an Assistant Professor working
in the Centre for Applied Neurogenetics and
Dr. Chantelle Hrazdil as Clinical Assistant
Professor in the Epilepsy program. Dr. Hrazdil
did her neurology training at UBC, followed by
subspecialty training in Calgary.
Division Members
Professor
Dr. Jason Barton
Dr. Oscar Benavente
Dr. Donald Calne (Emeritus)
Dr. Neil Cashman
Dr. Doris Doudet
Dr. Andrew Eisen (Emeritus)
Dr. Howard Feldman
Dr. Judy Illes
Dr. Seung Kim (Emeritus)
Dr. Martin McKeown
Dr. Joel Oger
Dr. Brian Pate (Emeritus)
Dr. Steven Pelech
Dr. Jon Stoessl
Dr. Vincent Sweeney (Emeritus)
Dr. Joseph Tsui
Dr. Yu Tian Wang
Clinical Professor
Dr. Andre Anzarut (Emeritus)
Dr. Jeff Beckman
Dr. Paul Bratty (Emeritus)
Dr. Stanley Hashimoto (Emeritus)
Dr. Michael Jones (Emeritus)
Dr. Robert Keyes
Dr. Gordon Robinson
Dr. Philip Teal
Associate Professor
Dr. Lorne Kastrukoff
Dr. Anthony Traboulsee
Dr. Helen Tremlett
Dr. Gillian Gibson
Dr. John Hooge
Dr. Manouchehr Javidan
Dr. Dean Johnston
Dr. Charles Krieger
Dr. Sian Spacey
Dr. Milton Wong (Emeritus)
Assistant Professor
Dr. Negar Asdaghi
Dr. Silke Cresswell
Dr. Claudia Jacova
Dr. Ging-Yuek Robin Hsiung
Dr. Austen Milnerwood
Dr. Jacqueline Pettersen
Dr. Christopher Bozek
Dr. Hannah Briemberg
Dr. Kristine Chapman
Dr. Stephen Clarke
Dr. Anthony Costantino
Dr. Virginia Devonshire
Dr. Esma Dilli
Dr. John Falconer
Dr. Dean Foti
Dr. Bradley Hallam
Dr. Sherri Hayden
Dr. Chantelle Hrazdil
Dr. Jeffrey Martzke
Dr. Michelle Mezei
Dr. Colleen Murphy
Dr. Alister Prout
Dr. Ana-Luiza Sayao
Dr. Brian Thiessen
Dr. Tiffany Townsend
Dr. Andrew Woolfenden
Clinical Instructor
Dr. Nicholas Bogod
Dr. Charles Tai
Dr. Michael Varelas
Adjunct Professor
Dr. Daniel Bub
Dr. Thomas Ruth
Dr. Vesna Sossi
Dr. Chris Tan
61
Neurology continues to be a key stakeholder
in the Djavad Mowafaghian Centre for Brain
Health, scheduled to open in late 2013.
EDUCATION
Undergraduate
Dr. Jon Stoessl
Professor and Head
ADMINISTRATION OVERVIEW
The Division of Neurology has major teaching,
research and clinical activities at Vancouver
General Hospital, UBC Hospital, and St. Paul’s
Hospital. There are 55 Neurology faculty members
whose primary appointment is in the Division,
with another 36 appointed as associate members,
4 as adjunct professors and 10 as emeriti. In 2012,
the Division had 5 Canada Research Chairs. The
faculty members comprise basic and cognitive
neuroscientists as well as clinicians.
The Division is nationally and internationally
recognized for its clinical and research programs in
multiple sclerosis, stroke and neurodegenerative
disorders including the dementias, motor neuron
disease and Parkinson’s disease, as well as its
program in neuroethics. It has had continued
success in obtaining peer reviewed grant funding
from agencies in Canada and internationally,
approximately $10M in 2012. Divisional members
make important contributions to both basic
neuroscience and clinical neurological literature.
This past year divisional members published
more than 140 papers in peer-reviewed journals.
Clinically, the Division provides province-wide
tertiary and quaternary care for a variety of
neurological disorders. The Division has clinical
outreach to many communities around the
province. Faculty members are actively involved
in teaching and supervising all levels of students
and trainees from undergraduate to post-doctoral
fellows. The Residency training program in
Neurology is one of the largest in the country.
In 2012, the Division welcomed Dr. Austen
The Division is involved in providing instruction
to UBC medical students (265) during the Brain
and Behavior section of Phase Two. Division
members lecture within the didactic calendar
on topics such as headache, dementia,
multiple sclerosis, Parkinson’s disease and
neuromuscular disorders.
The Neurosciences Clinical Skills course gives
students 18 hours of small-group instruction
(6 - 8 students) in learning to perform a
neurological examination. This consists of 30
student groups scheduled between January
and May using on average 24 neurologists
from the Division (includes VGH, UBCH and
SPH staff).
Support materials have been developed and
these are disseminated to distant sites as
printed and video material. These sessions
have been enhanced by the recruitment
of volunteer patients who are used to
demonstrate common deficits found on
neurological examination.
During third year, all Vancouver-based students
participate in a small-group (2 - 4 students)
bedside session. They evaluate a patient with
neurological disease following which a Division
member provides direct instruction.
Students enrolled in the Vancouver program
are provided with a two hour seminar
reviewing the neurological examination and
other topics in neurology. This is scheduled at
VGH during the first week of their medical CTU
rotation and is simulcast to distant sites (SPH,
Royal Columbian and Royal Jubilee Hospitals).
A 4-week elective/selective is offered in third
or fourth year (guidelines attached) to any UBC
medical student. The students participate at
either SPH or VGH sites in a primarily inpatient
Associate Member
Dr. Duncan Anderson
Dr. Peter Boulton
Dr. Donald Cameron
Dr. Todd Collier
Dr. Lyle Daly
Dr. John Diggle
Dr. Mirza Faisal-Beg
Dr. Matthew Farrer
Dr. Susan Forwell
Dr. Douglas Graeb
Dr. Alexandre Henri-Bhargava
Dr. Manraj Heran
Dr. Kennely Ho
Dr. Trevor Hurwitz
Dr. Amir Ilyas
Dr. David Katz
Dr. Wayne Lai
Dr. Blair Leavitt
Dr. Julian Lee
Dr. David Li
Dr. Ian Mackenzie
Dr. George Medvedev
Dr. Alex Moll
Dr. Wayne Moore
Dr. Russell Mosewich
Dr. Jeffrey Oyler
Dr. Sherrill Purves
Dr. Jacqueline Quandt
Dr. Lynn Raymond
Dr. Jacqueline Quandt
Dr. Adele Sadovnick
Dr. Noah Silverberg
Dr. John Stewart
Dr. Robert Stowe
Dr. Martin Sutton-Brown
Dr. Galina Vorobeychik
Dr. Rosemary Wilkinson
62
rotation. At VGH students may be scheduled to
Neurology as part of their medical CTU training. In
addition, the Division accepts students from other
Canadian and accredited foreign medical schools
for elective study.
During the last 2 years the demand for the elective
in neurology at VGH as increased dramatically.
This has led to a decision to increase the capacity
to 6 students for each block and limit international
students. This has allowed students from UBC and
all across Canada to participate.
The Division has expressed support for the
development of a mandatory neurology elective
in the proposed redevelopment of the medical
school curriculum.
Faculty members who are associated with the
Division provide clinical teaching in the Vancouver
Island and Prince George programs
Postgraduate
The Post Graduate Residency Training in
Neurology is fully accredited with the Royal
College of Physicians and Surgeons. It currently
has 26 residents at various levels of training
from PGY1 to PGY5. In the first two years of the
program the residents rotate through various
subspecialties such as Internal Medicine, ICU,
Emergency, Neurosurgery, Pain Medicine and
Palliative care, in addition to participating in
their first Neurology rotations. The years PGY35 are identified as core Neurology training
years. Residents acquire their inpatient training
at Vancouver General Hospital and St. Paul’s
Hospital. Many outpatient subspecialty clinics
are provided at UBC Hospital. The residents also
do a community outpatient rotation during their
training.
Madeleine Sharp received the Andre Barbeau
Prize from the Canadian Neurological Sciences
Federation, recognizing the research she did
during her neurology residency.
The Division held its 3rd annual Residents’
Research Day. The Don Paty Lecture was
delivered by Professor George Ebers of Oxford
University. We also held the 3rd Annual
Naveen Deshpande lectureship, in honor of a
senior resident who succumbed to leukemia
in 2009. The guest lecturer this year was Dr.
Angelika Hahn from the University of Western
Ontario.
Vancouver General Hospital Neurology
Service (Clinical Teaching Unit)
The in-patient service at VGH is located on T5
and 6 of the Pattison Pavilion. This is the only
dedicated hospital neurology clinical teaching
unit (CTU) in the province and has within its
mandate the provision of tertiary care for
complex neurological disorders. The inpatient
program features a specialized seizure
monitoring unit and Acute Stroke Unit. Life,
Limb and Threatened Organ policies approved
by the Vancouver Acute Medical Advisory
Committee are in place for accepting acute
stroke patients as well as other patients who
have neurological disorders requiring a higher
level of care.
A large percentage of all stroke patients
presented to the emergency room at VGH are
now admitted to the Neurology service for
acute management during the first 5-7 days of
their post stroke care. From there, the stroke
pathway includes transfer to the hospitalist
stroke service (now located on T6-A), other
appropriate rehabilitation facilities, or home.
Seven residents graduated from the program in
2012. Two graduating residents secured Clinical
Investigator Program funding for clinical research
fellowship training: Dr. Madeleine Sharp is doing
a Movement Disorders fellowship at Columbia
University in New York and Dr. Thalia Field is doing
a stroke fellowship at UBC and the University
of Calgary. Dr. Field was also one of 10 North
American residents (and the only Canadian
resident) to be awarded a prestigious AAN Clinical
Research Training Fellowship.
The VGH inpatient service is divided between
general and stroke neurology each with a
dedicated staff and resident team. Medical
students routinely rotate through these
services. Stroke neurology is available to
provide advice and invasive management
for acute stroke. Their activities include
development of a tele-stroke program which
allows expansion of acute stroke management
to facilities beyond the geographic region of
VA.
Over the course of their training the residents in
Neurology are actively involved in various research
projects. The Division held the third Neurology
Resident Research Day on June 13, 2012 where
neurology residents and graduate/post-graduate
neuroscience students presented their work. Dr.
The VGH and UBCH neurologists
provide important consultation services
within Vancouver Acute. Neurological
diagnostic services at VGH include
electroencephalography (EEG), intraoperative
monitoring (IOM), and electromyography
(EMG).
Ambulatory services provided include subspecialty clinics
for: movement disorders, multiple sclerosis, headache, ALS,
Alzheimer’s and other dementias, stroke, neuromuscular
disease, and neuro-oncology.
These clinics integrate a strong research environment for
each of the programmes, which in turn form the core of the
academic mission of the Division. The clinics also provide
important post-graduate educational activities for trainees
within the Division.
St. Paul’s Hospital: Division of Neurology
The Division of Neurology at St. Paul’s Hospital now comprises
a faculty of 8 active clinicians and clinician scientists as well
as 3 clinical Emeritus members. The Division of Neurology at
St. Paul’s Hospital has continued its longstanding traditions of
excellence in clinical teaching and patient care. The inpatient
activities of the Division are based at St. Paul’s Hospital.
However, active and busy consultative services are maintained
at St. Paul’s Hospital, Mount St. Joseph’s Hospital and B.C.
Women’s Hospital.
Clinical Services
Active ambulatory Neurology clinics devoted to general
Neurology are located in the Neurology/Neurophysiological
Department at St. Paul’s Hospital. Additionally, an active
and busy ambulatory Neurology Clinic devoted to general
Neurology is located in the outpatient department at Mount
St. Joseph’s Hospital. A wide range of clinical services related
to general neurology, HIV/AIDS, cerebrovascular disease/
stroke, neuromuscular diseases, epilepsy, multiple sclerosis
and the neurological complications of pregnancy are provided
through these many outpatient clinics. A busy Neurology
Rapid Access Clinic has been established in the medical
outpatient department at St. Paul’s Hospital. The purpose of
this clinic is to provide neurological assessments of patients
presenting to the emergency rooms at St. Paul’s Hospital and
Mount St. Joseph Hospital on an urgent basis.
The neurophysiology laboratories are located at St. Paul’s
Hospital and the activity levels have continued to increase
over the past several years. EEG, EMG and Evoked Potentials
Studies services are provided within these laboratories for all
inpatients and outpatients associated with the Providence
Health Care System and the associated referral base. Some
intraoperative neurophysiological capabilities exist as part
of the neurophysiology laboratory services. Approximately
4500 inpatient and outpatient neurophysiological studies
are performed in the neurophysiology laboratories at St.
Paul’s Hospital. EEG services have now been expanded to
provide a satellite EEG laboratory at Mt. St. Joseph Hospital
providing inpatient EEG services to that hospital. There are
five physicians providing EMG services to St. Paul’s Hospital
and the total Providence Health Care community. There are
two physicians providing EEG and Evoked Potential Services to
St. Paul’s Hospital and the Providence Health Care Community.
These laboratories provide a significant resource to the entire
Providence Health Care community and associated referral
base.
Teaching
The Faculty within the Division of Neurology at St. Paul’s
Hospital maintains widespread and substantial contributions
to education within the Faculty of Medicine and in the
community.
Undergraduate
The Undergraduate Training Program in the Division of
Neurology at St. Paul’s Hospital is under the direction of
Dr. Ana-Luiza Sayao. The Division maintains a significant
contribution to the undergraduate medical education program
through rotations of medical students on the inpatient,
outpatient and consultative services at St. Paul’s Hospital.
In addition, regular teaching at clerkship half days and on
Professors Rounds remains part of the Faculty commitment to
undergraduate medical education. Additionally, the Faculty
regularly participates in formal bedside clinical neurological
examination during several years of the undergraduate
medical education program. Medical students are primarily
from the University of British Columbia, but medical students
from other universities in Canada rotate through the
Neurology Service at St. Paul’s Hospital. The Faculty within the
Division of Neurology at St. Paul’s Hospital is always rated very
highly as to their teaching skills by the undergraduate medical
students. Finally, the Faculty regularly provides didactic and
practical teaching sessions to all undergraduate medical
students as part of their daily activities on the neurology
service at St. Paul’s Hospital.
Postgraduate
The Postgraduate Training Program in the Division of
Neurology at St. Paul’s Hospital is under the direction of
Dr. Ana-Luiza Sayao. The Division maintains a leading role
and a high profile in the teaching of resident trainees at
multiple levels. Clinical training in Neurology is provided
at the postgraduate level to residents training in Royal
College accredited specialty training programs in neurology,
internal medicine, physical medicine and rehabilitation,
pediatric neurology, family practice, oncology, psychiatry and
neuropsychiatry. Regular seminars as well as practical bedside
teaching sessions are provided by each member of Faculty
as part of their weekly activities at St. Paul’s Hospital. The
Faculty provide teaching in clinic settings to Neurology and
Internal Medicine residents. These clinics consist of private
office clinics, weekly Rapid Access clinics, Neurophysiology
(EMG) clinics, Mt. St. Joseph’s Hospital clinics and monthly
longitudinal clinics provided to core Neurology residents.
Formal teaching of Neurology residents includes Faculty
involvement in the teaching at Neurology Resident academic
half day. The Faculty provide didactic teaching to residents on
a monthly basis at St Paul’s Hospital Tuesday noon rounds.
Other Trainees
The Division of Neurology at St. Paul’s Hospital is also
responsible for the training of neurophysiology technology
students from BCIT and BC Children’s Hospital. These
students regularly rotate through the Clinical Neurophysiology
Laboratories at St. Paul’s Hospital.
Faculty members within the Division of Neurology are
regularly involved in continuing medical education activities
both within the Department of Medicine and Division of
Neurology as well as outside the Department of Medicine.
Many Division members participate as Faculty members in
seminars, conferences and other programs centered at St.
Paul’s Hospital, centered at other teaching hospitals within
the University of British Columbia and in other community
hospitals. The Faculty members from the St. Paul’s Hospital
Division of Neurology are regularly asked to speak on topics
arising from all subspecialty areas within the discipline of
clinical Neurology, and provide Neurology instruction for
the popular annual Internal Medicine Course run by the
Department of Medicine at St. Paul’s Hospital.
Outreach Programs
The many community-based neurology outreach programs
provided by the Faculty members of the Division of Neurology
of St. Paul’s Hospital include general neurology clinics,
neurophysiology clinics and some subspecialty neurology
clinics, particularly related to multiple sclerosis. The
outreach programs result in the physical presence of many
St. Paul’s Hospital Division of Neurology Faculty members in
other teaching and community hospitals throughout British
Columbia and the Yukon Territories. Faculty members from
the Division of Neurology at St. Paul’s Hospital regularly
provide on-site general neurology and neurophysiology clinics
in the following communities and their surrounding areas:
Sechelt, Gibsons, Squamish, Terrace, Kitimat, Prince Rupert
and Whitehorse. In addition, tertiary subspecialty multiple
sclerosis neurology clinics are also provided in the following
communities: Prince George, Fort St. John and Kitimat.
Clinical Research
The research activities in the Division of Neurology at St. Paul’s
Hospital consist of involvement in the UBC Clinic for Alzheimer
Disease (Dr. Hsiung), UBC Multiple Sclerosis Clinic (Dr. Sayao)
and VGH Neuromuscular Diseases Unit (Dr. Chapman).
Future Directions
The Division of Neurology at St. Paul’s Hospital will continue
to build on its current strengths to ensure the highest quality
of clinical, teaching and academic activity for the Division of
Neurology, Department of Medicine, Faculty of Medicine and
the University of British Columbia. This has become more
important and more challenging to all Faculty members over
the last several years coincident with the expansion of the
University of British Columbia Medical School. The members
of the Division of Neurology will work closely with the other
hospitals within Providence Health Care and within the
University of British Columbia Community to meet the needs of
the patients, students and university within and outside of the
Vancouver area. The St. Paul’s Hospital Division of Neurology
continues to actively support a return of neurosurgical services
to St. Paul’s Hospital and Providence Health Care. Future
recruitment goals include the strengthening of EEG/Epilepsy
resources and recruitment of a Neuro-ophthalmologist to work
together with the Division of Neurology and Department of
Ophthalmology.
PHYSICAL MEDICINE & REHABILITATION
In 2012, there were 28 medical student elective
rotations in Vancouver: 15 from UBC, 12
from other Canadian medical schools and 1
international student.
Division Members
Professor
Dr. Andrei Krassioukov
Clinical Professor
Dr. Hubert Anton
Postgraduate:
The Postgraduate program continues to be
successful in terms of competitive recruitment
of new residents and in the success of our
new graduates. There are 13 residents in the
program. Dr. Dan DeForge has joined Dr. Yao in
co-directing the program, and he brings a wealth
of experience to the program.
Dr. Daniel De Forge
Dr. Jaime Guzman
Dr. Wolfgang Schamberger
Dr. Andrea Townson
Dr. Andrew Travlos
Dr. Theo Van Rijn (Emeritus)
Dr. Mark Adrian
Dr. James Filbey
Dr. Heather Finlayson
Dr. Gabriel Hirsch
Dr. David Koo
Dr. Lynne MacKean
Dr. Viem Nguyen
Dr. Russell O’Connor
Dr. Noah Silverberg
Dr. Heather Underwood
Dr. Jennifer Yao
Dr. Michael Vondette
Clinical Instructor
Dr. Anibal Bohorquez
Dr. Lisa Caillier
Dr. Mark Crossman
Dr. Andrew Dawson
Dr. Anita Fan
Dr. Carrie Graboski
Dr. Steven Helper
Dr. Herman Lau
Dr. Catherine Paramonoff
Dr. Rajiv Reebye
Dr. Stephen Vallentyne
Dr. Elliot Weiss
Dr. Rhonda Willms
Dr. Paul Winston
Adjunct Professor
Dr. Lyle Gross
Associate Member
Dr. Janice Eng
Dr. Bill Miller
Dr. Jacqueline Purtzki
Honorary Member
Dr. Claire Weeks
65
Dr. Andrea Townson
Clinical Associate Professor & Head
The UBC Division of Physical Medicine &
Rehabilitation (PM&R) faculty members are
involved with patient care, teaching and research.
Our Division continues to grow throughout the
province as we welcome Division members from the
distributed sites for UBC medical school. Outside
the Lower Mainland, our Division has members in
Kamloops, Kelowna, Nanaimo and Victoria.
Division members teach residents and medical
undergraduate students, as well as undergraduate
and graduate students in related rehabilitation
disciplines.
Research activities focus on disease specific issues
related to our patient population, as well as
disability issues for the population at large.
Education
We are continuing to develop our academic
curriculum and have introduced case based
learning into half day. The program strives to
provide balanced education for the residents
in all aspects of the CanMEDS roles. Residents
are provided with the tools to use technology
to enhance their interactive learning. Our
educational leaders are working hard to improve
on the program based on resident feedback.
The program is also seeking to increase elective
and educational opportunities with Division
members practicing outside of metro Vancouver.
Drs. Koo, Willms, and Reebye continue to be
part of the Royal College specialty examination
committee for PM&R and Dr. Yao is now the vicechair of the specialty committee for PM&R.
Continuing Professional Development:
Dr. Mark Adrian is the Continuing Professional
Development (CPD) Coordinator. The Division
is committed to continuing professional
development. We run weekly province wide
rehabilitation rounds and monthly quality
improvement and research rounds. Province
wide rounds are broadcast to other centres in
British Columbia, outside the Lower Mainland.
Dr. Jaime Guzman continues to support the
residents in the selection and analysis of articles
for the scheduled monthly Division Journal Club.
All Division members are actively engaged in
teaching the residents and medical students.
Excellence in education is recognized through annual
teaching awards and in 2013 a new category “Best In 2012, a CPD needs assessment survey showed
a high satisfaction level for the quality of our
Resident Educator” will be added to the awards.
rounds amongst the Division members and
residents. Goals of future CPD activities include
Undergraduate:
hosting educational workshops in areas such as
Dr. Herman Lau is the Undergraduate Coordinator
musculoskeletal ultrasound.
for the Division. Division members continue
to provide a strong presence during the
Research
musculoskeletal (MSK) skills block in 2nd year. In
the Okanagan, Year 3 students attend weekly PM&R
clinics and Year 3 and 4 students can take elective Dr. Andrei Krassioukov is the Division Research
Director and Chair of the Division Research
rotations in PM&R in Vancouver and Victoria.
Advisory Committee. Dr. Hugh Anton is the
GF Strong Research Coordinator. Division members actively
participate in regular research education sessions focused on
the relevance of research to the professional development
needs of the Division. Since 2009, these regular sessions have
been interdisciplinary with members from the Departments
of Physical Therapy and Occupational Science and Therapy
attending on a regular basis. The Division Research Advisory
Committee continues to meet and develop a strategic planning
process for research.
Notable research achievements in 2012 include:
•
•
•
Dr. Andrei Krassioukov was elected as a Fellow in the
Canadian Academy of Health Sciences.
Dr. Andrei Krassioukov was awarded $1.9 million from CIHR
for his reaserch on cardiovascular health in Canadians living
with spinal cord injury.
Dr. Patricia Mills received a VCHRI Mentored Clinician
Scientist Award for her work on autonomic dysfunction
following spinal cord injury.
In 2012, the Division, in collaboration with the Vancouver
Coastal Health Research Institute, organized the Third Annual
GF Strong Rehab Centre Research Day. Dr. Kathleen Martin Ginis
from McMaster University was the plenary speaker.
Clinical Activities
Our members consult and provide rehabilitation services
to persons ranging from the very young to the very old.
We manage inpatient and outpatient programs for persons
who have suffered spinal cord injury, acquired brain injury,
neuromuscular abnormalities and cardio-pulmonary
dysfunction. Inpatient services are provided at several sites in
the Lower Mainland, including GF Strong Rehab Centre, Holy
Family Hospital, Eagle Ridge Hospital and Sunny Hill Health
Centre.
Members of our Division continue to provide consultation
services to Vancouver Acute, St. Paul’s Hospital/Providence
Hospitals, as well as hospitals in the Fraser Health Authority,
Vancouver Island Health Authority and Interior Health Authority.
The Division also provides regular outreach clinics in
Whitehorse, Yukon.
The distributed medical school sites provide an opportunity for
our Division to build further on our clinical and academic ties
throughout the province.
R E S P I R AT O RY M E D I C I N E
Respiratory Division.
Division Members
Professor
Dr. Tony Bai
Dr. Vincent Duronio
Dr. John Fleetham
Dr. Stephen Lam
Dr. Robert Levy
Dr. S.F. Paul Man
Dr. David Ostrow
Dr. Peter Paré
Dr. Jeremy Road
Dr. Francis Ryan
Dr. Don Sin
Dr. Stephanus Van Eeden
Dr. Pearce Wilcox
The Program has 6 clinical fellows currently
in the program. Dr. Keith Wally continued his
leadership of the IMPACT training program which
is a CIHR funded training program designed to
develop a critical mass of scientists researching
in the respiratory, cardiovascular and critical care
domains. The program is very successful and
continues to build on the excellence of Dr. Peter
Paré’s leadership, who is the inaugural Director.
Many divisional members are primary or cosupervisors of Master’s, Ph D and post doctoral
students in a wide range of trainee programs
across many different disciplines.
Professor Emeritus
Dr. Raja Abboud
Dr. Moira Yeung
Clinical Professor
Dr. Kevin Elwood
Dr. Nasreen Khalil
Dr. Edina (Barbara) Nakielna
Dr. Juan Ronco
Dr. Edward Allen
Dr. Paul Champion
Associate Professor
Dr. Christopher Carlsten
Dr. Andrew Sandford
Dr. Scott Tebbutt
Dr. Iqbal Ahmed
Dr. Richard Cohen
Dr. Tharwat Fera
Dr. Jennifer Wilson
Assistant Professor
Dr. Victoria Cook
Dr. Denise Daley
Dr. Mahyar Etminan
Dr. Chris Miller
Dr. Chris Ryerson
Dr. Mohsen Sadatsafavi
Dr. James Johnston
Dr. Susan Kwan
Dr. Edward Lawson
Dr. Anne McNamara
Dr. Annette McWilliams
Dr. Roland Nador
Dr. J. Douglass Rolf
Dr. Tawimas Shaipanich
Dr. John Swiston
Dr. Mark Turner
Clinical Instructor
Dr. Randy Chung
Dr. Samir Malhotra
Dr. Graeme McCauley
Dr. Sharla-Rae Olsen
67
Professor & Head
Administration Overview
Ms. Margie Bell continues to provide excellent
administrative support for the division in 2012,
as well as the routine day to day activities of the
division and preparing for accreditation of the Post
Graduate training program. There have also been
significant additional administrative duties relating
to the evolving Institute for Heart + Lung Health.
Experimental Medicine
Dr. Vince Duronio is the Director of the
Experimental Program, as well as a Divisional
member. In total there are 8 post-doctoral
fellows, 11 PhD students, 5 Master’s students
affiliated with the Respiratory Division.
Continuing Professional Development
Divisional members contribute extensively on
a Provincial, National and International level to
professional development. The scope of these
contributions is too abundant to list in this
brief report, but reflects the major productivity
of the division in terms of research activity
Mrs. Kamila Kalsi provides administrative support
for St. Paul’s Hospital divisional activities. Given the as outlined below. It also reflects the major
contributions members have continued to
expanded level of activity within the division and
the ongoing delegation of administrative duties from make in terms of national and international
the Department of Medicine to the divisional level, guideline development in many therapeutic
areas. For instance, Division Head, Dr. Mark
further administrative support will be required.
FitzGerald is the chair of the Global Initiative
for Asthma (GINA) Executive and a former chair
Education
and current member of its Science Committee.,
GINA is preeminent in setting international
Undergraduate
evidence based guidelines for the management
of asthma and Dr. Don Sin is the only Canadian
Dr. Jeremy Road (VGH) and Dr. Don Sin (SPH)
scientific member of the international GOLD
coordinate undergraduate elective programs for
(Global initiative for chronic Obstructive Lung
medical students. In this regard, the increased
Disease) scientific committee, which sets
size of the medical school has presented new
international guidelines for the management
opportunities and challenges. Dr. Richard Cohen
has responsibility for the PBL pulmonary block and of chronic obstructive pulmonary disease
brings specialty expertise in education to this role as (COPD). The major divisional activity is the UBC
well as his specialty training in Respiratory Medicine. Respiratory Medicine Update which again was
a very successful meeting co-sponsored with
the BC Lung Association and held in Vancouver
Post-graduate
in March 2012. In 2012 it co-presented with
the UBC Cardiology Division This meeting has
Dr. Frank Ryan leads the Post Graduate Fellowship
Program; review of the fellowship program. He has expanded significantly in parallel with the
ongoing evolution of the Institute for Heart and
been ably assisted in this regard by Ms. Margie
Lung Health. It now includes the Lung Health and
Bell, who in addition to her Fellowship activities
Air Quality meeting. In conjunction with these
also provides administrative support for the UBC
Associate Members
Dr. Yosef Av-Gay
Dr. Najib Ayas
Dr. Michael Brauer
Dr. Patricia Camp
Dr. Harvey Coxson
Dr. Delbert Dorscheid
Dr. Neil Eaves
Dr. John English
Dr. Mehdi Keshmiri
Dr. Alan Lowe
Dr. John MacCarthy
Dr. John Mayo
Dr. Darlene Reid
Dr. Clive Roberts
Dr. Bruce Sanders
Dr. John Tsang
Dr. Shannon Walker
Dr. Sheila Webster
occupational lung diseases (Dr. Chris Carlsten)
and tuberculosis (Drs. FitzGerald, Johnston,
Elwood and Cook). There is a major collaborative
link between VGH based investigators (Drs. Yee,
Mayo, Lam, and McWilliams) and the BC Cancer
Agency focusing on better understanding of the
pathogenesis, prevention and management of
lung cancer. Health outcomes research continues
to develop across both SPH and VGH with Dr.
Research
FitzGerald collaborating with a number of health
outcomes researchers most notably Dr. Carlo
The UBC Division has an international reputation
Marra and Larry Lynd. Dr. Mohsen Sadatsafavi,
for excellence in research which spans the 4 CIHR
further strengthens this program of research
Pillars from state of the art basic research through
with his recruitment as a PhD scientist to the
to population health. A conservative estimate of
UBC Respiratory Division and is based at VGH
dollars generated for lung related research within
and the Centre for Clinical Epidemiology and
the division for 2012 is $5,757,078.
Evaluation. He has an interest in respiratory
health outcomes with a special emphasis on
In 2012, divisional members were instrumental in
health economics. In his brief time in the division
securing a major infrastructural award from the
Mohsen has been particularly productive. In
Canada Foundation for Innovation (CFI) for $6.25
addition in 2012 Dr. Roland Nador was recruited
million to enhance our translational research and
to the division and will work on the Lung
obtaining a $7.2 million Genome Canada/CIHR
transplant Program as well as providing back
Award to discover and implement “personalized
up coverage for the pulmonary hypertension
medicine” for patients with COPD. Major peer
program. Dr. Nador received excellent training
reviewed publications totaled over 213 papers for
2012. This high level of productivity builds upon the and a subsequent faculty appointment in lung
transplant medicine at Stanford University before
recognition of UBC as being number 3 globally and
moving to the University of Alberta. Dr Jordan
number 1 in Canada in COPD related research over
Guenette was recruited to St. Paul’s Hospital with
the last ten years. Only Imperial College in London
a primary appointment in the Department of
and Harvard University in Boston were ahead of
Physical Therapy. He is an associate member of
UBC.
the UBC Respiratory Division. In addition Dr. Neil
Eaves form the UBC Okanagan campus likewise
The UBC James Hogg (iCAPTURE) Research Center
(JHRC) at SPH continues to provide strong leadership has an associate membership of the division.
Both Jordan and Neil bring strong expertise in
in basic and translational research with a particular
assessing the cardio pulmonary response to
focus on airways biology and COPD in particular.
exercise as well as the interaction of heart and
There is also excellent clinical research in cystic
lung in health and disease.
fibrosis, and a rapidly developing basic and clinical
research program in interstitial lung disease.
Divisional members based at JHRC include Drs. Scott Clinical Activities
Tebutt, Andrew Sandford and Denise Daley, who are
The UBC division provides tertiary and
focused on understanding genetic determinants of
quaternary services in a distributed model
lung disease; Drs. Don Sin, Wan Tan and Stephan
van Eeden, who study the burden of chronic airway with regional and provincial services in
Lung Transplant (Medical Director Dr. Levy),
diseases in Canada and evaluate heart and lung
Pulmonary Hypertension (Director Dr. John
interactions and the effects of cigarette smoke
Swiston), chronic home ventilation program
and air pollution on the lungs; and Drs. Paul Man
(Director Dr. Jeremy Road), occupational lung
and Peter Paré are senior clinician scientists, who
diseases (Director Dr. Chris Carlsten) and
provide mentorship and leadership for the entire
Tuberculosis Ward (Director Dr. Mark FitzGerald)
pulmonary research investigators at JHRC and
based at VGH. Other specialty clinics at VGH
throughout the UBC system.
include COPD (Dr. Road et al), Asthma (Dr.
FitzGerald), Interstitial Lung Disease (Dr. Khalil),
Basic research also occurs at The Lung Centre at
VGH with strong leadership from Drs. Vince Duronio, lung cancer (Dr. Lam), and pleural diseases
Nasreen Khalil and Chris Carlsten, however its major (Dr. Ryan et al). The Provincial cystic fibrosis
emphasis continues to be clinical and epidemiologic program is based at St, Paul’s Hospital with
Dr. Pearce Wilcox as the medical director of
research, focusing on sleep disordered breathing
(Drs. Ayas, Fleetham, Ryan), interstitial lung disease the program. Dr. Brad Quon, who is currently
a CIHR fellow, will be recruited in 2014 to
(both clinical and basic-Dr. Nasreen Khalil), airways
enhance the academic and clinical mission in
diseases (Drs. Jeremy Road, and FitzGerald),
meetings Dr. Jonathan Samet gave the Fifth Annual
David Bates Memorial Lecture focusing on setting air
quality standards; risk, certainty and public health.
In addition in 2012 in partnership with the BC Lung
Association and Heart and Stroke members of the
division participated in a Patient Lung Health Forum
which was held in parallel with the other meetings.
68
cystic fibrosis. SPH has specialty clinics for severe asthma (Dr.
Del Dorscheid), Pulmonary scleroderma (Dr. Pearce Wilcox et
al.), interstitial lung diseases (Dr. Chris Ryerson), and COPD
(Drs. Don Sin and Stephan van Eden) and vibrant interventional
bronchoscopy program led by Dr. T. Shaipanich. There is also a
COPD-HIV clinic at SPH to address the growing burden of lung
diseases in this population of patients. UBC Hospital is the site,
for the regional program in sleep disordered breathing. Dr.
Fleetham is the medical director of this program. Both sites
provide comprehensive state of the art management across the
continuum of care from ambulatory to acute, managing a broad
range of respiratory diseases. In addition there is a respiratory
consultation service provided to Mount St. Joseph’s Hospital,
GF Strong and Pearson Hospitals. Both sites continue to develop
ambulatory care related resources and expanded pulmonary
rehabilitation capacity as well as innovative extension of care
into the community best exemplified by an excellent program
based at SPH with links to community rehabilitation. There are
continued efforts to create better models of chronic disease
management with COPD and asthma clinics continuing to
evolve based on multi-disciplinary models of care. Under the
leadership of Dr. Mark FitzGerald members of the division
in partnership with much community based respirologists
continues to build upon the successful $2.1 million dollar
Lower Mainland Innovation Fund awarded in 2009. This award
has allowed for expanded access to spirometry services as
well as the development of common clinical pathways and
standardization of COPD related services across both Vancouver
Coastal and Fraser Health Authorities. More recently both sites
have been awarded support through a Patient Focused Funding
initiative to improve the management of COPD with a total of
six nurse practitioners and respiratory therapists recruited to
improve transition from acute to community care with an overarching aim of reducing length of stay and hospitalizations. The
program which ran through 2012 was particularly successful
and a process is being put in place to ensure ongoing funding.
Both sites have Morbidity and Mortality Rounds and have been
proactive in including Fellows and trainees in this process.
The latter involvement has facilitated many quality assurance
projects.
69
RHEUMATOLOGY
well as Administrator for St. Paul’s and VGH
Rheumatology.
Division Members
Professor
Dr. Andrew Chalmers
Dr. John Esdaile
Dr. John Esdaile is on the Executive Committee
of the Western Alliance of Rheumatology, along
with faculty members from the Universities of
Alberta, Calgary, Saskatchewan, and Manitoba,
and in June 2012, they held the Tenth Annual
Western Alliance of Rheumatology Meeting,
which is a collegial gathering of rheumatologists
from the Western provinces and focuses on
practical clinical and research topics.
Professor Emeritus
Dr. Denys Ford
Dr. Harold Robinson
Dr. Ian K-Y Tsang
Clinical Professor
Dr. Kenneth Blocka
Dr. Graham Reid
Dr. Kamran Shojania
Dr. Barry Koehler
Dr. Caroline Patterson
Associate Professor
Dr. Jolanda Cibere
Dr. Diane Lacaille
Dr. Stephanie Ensworth
Dr. Simon Huang
Dr. John Kelsall
Dr. Alice Klinkhoff
Dr. Robert Offer
Dr. Rhonda Shuckett
Dr. John Wade
Assistant Professor
Dr. Juan Avina-Zubieta
Dr. Maziar Badii
Dr. Milton Baker
Dr. David Collins
Dr. Cathy Flanagan Simkus
Dr. Shahin Jamal
Dr. Raheem Kherani
Dr. Jason Kur
Dr. Alison Kydd
Dr. Daniel B. McLeod
Dr. Jennifer Reynolds
Dr. Stuart Seigel
Dr. John Watterson
Clinical Instructor
Dr. Anick Godin
Dr. Jean Gillies
Adjunct Professor
Dr. Jerry Tenenbaum
Associate Members
Dr. Hyon Choi
Dr. Jan Dutz
Dr. Jacek Kopec
70
Dr. Barry Koehler is Chair of the Canadian
Rheumatology Association (CRA) Human
Resources Committee. Dr. Shojania sits on the
Royal College Specialty Committee. Dr. Diane
Dr. Kam Shojania
Lacaille serves on the Canadian Arthritis Network
(CAN) Research Management Committee. Dr.
Alice Klinkhoff is a Board member of The Arthritis
Society, B.C. and Yukon. Dr. Robert Offer is on
The UBC Division of Rheumatology currently consists the CRA Board of Directors and the CRA Access
to Care Committee. He is also CRA liaison to
of 35 members. Rheumatology consultation
services are offered at Vancouver Hospital & Health the AHPA, and is Chair of the BC PharmaCare
Arthritis Biologics Committee.
Sciences Centre, St. Paul’s Hospital, Richmond
Hospital, and G.F. Strong Rehabilitation Centre.
Ambulatory care services are available at Mary Pack The Seventh Annual BC Rheumatology
Invitational Education Series (BRIESE), a two-day
Arthritis Centre, the Gordon and Leslie Diamond
educational conference for British Columbian
Health Care Centre, St. Paul’s Hospital, and in
private practices throughout Metro Vancouver, the rheumatologists, was once again successfully
Okanagan Valley, and Victoria. The Arthritis Society organized by Drs. John Wade, John Watterson,
Maziar Badii and Jason Kur.
(BC & Yukon Division) provides patient education
and resources available through the Learning Centre
The Division said farewell to one of our
based at the Mary Pack Arthritis Centre.
founding members in October, when Dr.
Many divisional faculty are members of the Arthritis George Price passed away. Dr. Price was one
of the original UBC Rheumatologists, and the
Research Centre of Canada; a multidisciplinary
first rheumatologist from British Columbia
clinical research and clinical trials facility affiliated
to take care of sick patients with Systemic
with both the University of British Columbia and
Lupus Erythematosus, vasculitis and unusual
the Vancouver Coastal Health Research Institute.
The Arthritis Research Centre focuses on “Practical diseases. Back in the 1960s, the UBC Division of
Rheumatology included Dr. Harold Robinson and
Research for Everyday Living” for people with
Dr. Denys Ford. Dr. Price was their first Fellow
arthritis.
who joined them as faculty in 1965. He retired
from faculty in 1994.
Dr. Kam Shojania continues as Head and
Postgraduate Program Director for UBC
Rheumatology, and at the end of 2012, completed Dr. John Esdaile was chosen as one of the
2012 Masters of the American College of
his first of two terms.
Rheumatology. Under his leadership in
establishing the Arthritis Research Centre of
Dr. Kam Shojania is Head of both the St. Paul’s
Canada - a unique, productive research idea,
Division and the Vancouver General Hospital
Vancouver became an international leader in
Division. Dr. John Watterson continues to oversee
rheumatology epidemiology research. Over
the hospital training program at G.F. Strong
Hospital. Dr. Alice Klinkhoff is Director of the Mary his years, Dr. Esdaile trained and recruited
outstanding new faculty for UBC and forged
Pack Arthritis Centre. Dr. John Esdaile continues
strong international collaborations. He has been
as the Scientific Director of the Arthritis Research
extraordinarily productive in his own original
Centre. Miss Tracey Ernst continues as Division
and imaginative research and has mentored
and Postgraduate Program Administrator, as
researchers around the world.
In 2012, Dr. John Esdaile was also awarded the 2012 Jonas
Salk Award by the March of Dimes Canada. This is a lifetime
achievement award presented annually to a Canadian scientist,
physician or researcher who has made a new and outstanding
contribution in science or medicine to prevent, alleviate or
eliminate a physical disability.
of July, 2012, for our trainees and for rheumatology trainees
from programs across Canada. This course is organized by
Dr. Kam Shojania and involves the majority of the divisional
faculty. It continues to be the only course of its kind in Canada,
and provides new rheumatology fellows with a comprehensive
background in the basic skills required in the academic and
clinical practice of rheumatology.
RESEARCH
Members of the Division continue to be active in the Arthritis
Research Centre (ARC), which relocated this year to a brand new
site in Richmond known as thethe Milan Ilich Arthritis Research
Undergraduate: Dr. Rhonda Shuckett is in charge of the
Centre. This transformative new site was made possible by a
Rheumatology Undergraduate Committee and co-chairs the
musculoskeletal undergraduate block. She designed the week- $4 million donation to the ARC by the Milan & Maureen Ilich
Foundation, and by the donation of Richmond office space by
long Rheumatology Problem-Based Learning for UBC’s second
-year Medical and Dental program, and provides approximately Progressive Construction Ltd. The Arthritis Research Centre
includes faculty from the Division of Rheumatology, the
eight lectures to the full class of students. Her week is one of
Department of Orthopedics, the Department of Health Care &
the highest rated weeks in Medicine Year Two.
Epidemiology, the Department of Pharmaceutical Sciences and
the School of Rehabilitation Sciences, as well as faculty from the
A number of our faculty provide clinic and teaching time
Centre for Health Evaluation and Outcome Studies at St. Paul’s
for medical student rotations. In 2012, approximately 19
Hospital, and the Centre for Hip Health and Mobility and the
fourth-year medical students from UBC and other universities
Centre for Clinical Epidemiology and Evaluation at Vancouver
spent two to four-week electives with St. Paul’s Hospital and
Vancouver General Hospital Rheumatology. In addition, several Acute.
rheumatologists at both hospitals are now working with thirdCurrent research is funded by the Canadian Institutes of Health
year medical students in their clinics.
Research, the Michael Smith Foundation, the Arthritis Society
Postgraduate: Dr. Kam Shojania has been the Program Director of Canada, and National Institutes of Health (U.S.). Faculty
for the Postgraduate Training Program for four years. The faculty members hold scholarships from the Arthritis Society of Canada,
provides 4-week elective rotations in Rheumatology to residents the Canadian Institutes of Health Research, and Canadian
Arthritis Network.
in Internal Medicine and other specialties from UBC and from
other universities. In 2012, approximately 83 residents from
Internal Medicine, Family Practice, Neurology, Dermatology,
CLINICAL ACTIVITIES
Ophthalmology, Physical Medicine and Rehabilitation, and
Maternal Fetal Medicine spent elective rotations in one of our
The Mary Pack Arthritis Program is a provincial program
two teaching sites, St. Paul’s or Vancouver General, as well as
administered through the Vancouver Coastal Health Authority.
private practices in Metro Vancouver.
Services and programs include drug and disease monitoring
clinics, multidisciplinary rehabilitation in the inpatient and
The two-year Postgraduate Training Program in Rheumatology
continues to be the second-largest clinical rheumatology training outpatient setting, a young adult transition program, a rapid
centre in Canada. The program typically receives funding from access clinic for diagnosis and initial treatment of rheumatoid
the Ministry of Health for two or three trainees every year, and arthritis, infusion services for biologic medications, and an
inpatient service in the G.F. Strong Rehabilitation centre.
one or two internationally-funded trainees are considered.
Active in-patient, ambulatory care and research training is
done at Vancouver Hospital & Health Sciences Centre, St. Paul’s The Mary Pack program coordinates the travel of twelve Division
Hospital, G.F. Strong Rehabilitation Centre, the Arthritis Research faculty to 25 remote locations in British Columbia, for the
Centre, and in private practices throughout the Lower Mainland Rheumatology Travelling Consultation Service. This program’s
goal is to provide education, consultation and treatment services
and elsewhere in the province.
to communities with populations of 5,000 which do not have
a rheumatologist accessible within two hours driving time, as
The postgraduate program is currently comprised of four
well as to numerous isolated First Nations communities. The
first-year trainees and one second-year trainee. The trainees
Mary Pack program also provides physiotherapy, occupational
participate in mandatory rotations at Vancouver Acute, St.
therapy, and access to social workers and vocational, as well as a
Paul’s Hospital, G.F. Strong, BC Children’s Hospital, Physical
full spectrum of educational workshops for patients. Funding of
Rehabilitation, and in numerous drug/disease monitoring
clinics and community rheumatology practices throughout their all physician services for the Mary Pack Program is through the
Ministry of Health APP program.
training.
TEACHING
For the twelfth consecutive year, the Division offered the “Basic
Skills Course for Rheumatology Fellows” in the first full week
The Early Rheumatoid Arthritis clinic in the Mary Pack Arthritis
Program has a focus on triaging patients to determine early
inflammatory arthritis, so that treatment can be started within
the “window period”.
Ambulatory care clinics offered at St. Paul’s Hospital include
the Limited Scleroderma Clinic with Dr. James Dunne, and the
Combined Lung Scleroderma Clinic, with Drs. Dunne and Wilcox,
of the Division of Respiratory Medicine. The Lupus Clinic,
directed by Dr. Jennifer Reynolds and staffed by Dr. Ken Blocka,
has been operating for over two years, and continues to grow,
seeing new patients referred by general practitioners as well as
complicated consults from fellow rheumatologists. The unique
Dermatology And RheumaTology (DART) clinic continues into its
second year, and incorporates both a dermatologist (Dr. Sheila
Au) and a rheumatologist (Dr. Kam Shojania) who see referrals
with autoimmune rheumatic diseases who have cutaneous
disease.
The G.F. Strong Rehabilitation Centre’s Arthritis Unit, directed
by Dr. John Watterson, offers post-operative and rehabilitative
services to rheumatology patients along with specialized
physiotherapy, occupational therapy and vocational counseling.
Inpatient services are offered at Vancouver Acute and St. Paul’s
Hospital. Dr. Raheem Kherani has developed an outpatient
program at GFS in order to facilitate early discharge and to
optimize rehabilitation potential.
Dr. Robert Offer in Penticton teaches undergraduate and
postgraduate trainees and is involved in many continuingeducation events for physicians. Penticton has a well-staffed
Mary Pack Treatment Centre at Penticton Regional Hospital
and a drug monitoring clinic covering more than 500 active
rheumatoid arthritis patients. Dr. Offer does outreach traveling
consultation clinics and telemedicine to Creston, as well as
research and clinical trials.
Telehealth continues in Trail and Smithers with Dr. Chalmers
and Dr. How. Research comparing evaluation and initiation of
treatment of new onset RA by Telehealth versus in-person is
ongoing.
OFFICE OF EDUCATION
Dr. Adam Peets
Associate Head, Education
October 1, 2012 - present
Ms. Kathy Standeven
Senior Education Manager
October 1, 2012 - present
Background:
Over the last ten years, the education portfolio within the Department has experienced significant change as we expanded into a
province-wide distributed program growing from approximately 600 medical students and core Internal Medicine residents in the
Lower Mainland to more than 1200 trainees now disbursed across the province in greater than 25 sites. In response to program
expansion, combined with ever changing patient-care needs and innovations in medical education, the Department commissioned
an Education Task Force in 2011 to identify and prioritize the education issues to be addressed. A key recommendation was the
need to dedicate strategic leadership to ensure continuity of direction and progress to sustain and advance the excellence of our
education program. As a result, the Department of Medicine’s Office of Education was created in October, 2012.
2012 Accomplishments and Highlights:
From October 2012 until the end of the calendar year, members of the Office of Education spent the majority of their time laying
the groundwork for key initiatives moving forward. However, within that three month period, there were also a number of accomplishments and highlights as outlined below:
•
•
73
October 1, 2012: Dr. Adam Peets, appointed Associate Head, Education and Ms. Kathy Standeven appointed Senior Education
Manager.
o Includes the administrative and faculty leads for the Undergraduate and Postgraduate training programs within the Department.
o Branding process initiated.
Vision and Mission Statement Created
o Vision: To create a culture that values education.
o Mission: To support and advance learning, education scholarship and innovation across the Department of Medicine
74
•
Environmental Scan Initiated
o Dr. Peets has begun to meet with faculty members for their input into the assessment of current needs as the starting point for the creation of the strategic plan.
o Ms. Standeven met with the Program Administrators from the subspecialty training programs within the Department to create a network of administrators and to get their input on the strategic plan for education.
o This process has proven to be extremely valuable for Dr. Peets and Ms. Standeven to gain a better understanding of the educational climate within the Department
•
Accreditation
o Ms. Standeven invested a significant amount of time in helping to create the accreditation documents for the Core Internal Medicine Training Program.
o Dr. Peets and Ms. Standeven met with key stakeholders in subspecialty training programs to review the accreditation process and questions
•
Undergraduate Curriculum Renewal Process:
o Dr. Peets member of Academic Learning Communities Working Group
•
Initial Steps Taken on a Number of Key Initiatives Going Forward, including:
o Centralized Assessment System for storing and accessing evaluation data for Faculty, trainees and rotations.
o Simulation
o Ultrasound training
o Formative Peer Review of Teaching
•
Summative Review of Teaching (SPROT) Process
o Drs. Eva and Peets created a Department-specific SPROT policy for academic Faculty members undergoing the process of promotion and/or tenure.
CLINICAL INVESTIGATOR PROGRAM
Dr. Anita Palepu
Professor & Director
PROGRAM OVERVIEW
The Clinical Investigator Program (CIP) program is an integral
component of the Department of Medicine. Its main goals
are to integrate promising medical students, residents
and fellows into an academic environment that sustains
and nurtures academic interests. Dr. Palepu, in her role as
director of this program, has been advocating for young
investigator participation and interest in research activities.
The CIP program is a resource, which permits divisions
within the Department of Medicine to leverage funding
opportunities in order to support the academic endeavors
of those divisions.
The Faculty Clinical Investigator Program is a 2-year
program, which has the potential to fund at least 6
individuals each year. Currently, we have 8 young
investigators enrolled in the Faculty CIP program from
the Department of Medicine in 2012 include: Tabassum
Firoz (General Internal Medicine –Y2), Katherine Plewes
(Infectious Disease –Y2), Liam Brunham (General Internal
Medicine – Y1), Madeline Sharp (Neurology – Y1), Roseanne
Yeung (Endocrinology – Y1), and Thalia Field (Neurology
– Y1), Alim Harji (Respirology – Y1) and Queenie Dihn
(Infectious Diseases – Y1).
We had one core internal medicine trainee, Asher
Mendelson (PGY3) take a research year over his PGY3
and 4 to complete a research project with members of
the Division of Nephrology and the UBC Department of
Chemistry. He is enrolled in the Masters of Experimental
Medicine Program. His funding was provided through the
UBC Department of Medicine and he will be completing his
training June 30, 2013.
Given the importance of the CIP program to the growth
and sustainability of research programs, the director
is integrated into key activities of the Department of
75
Medicine. This includes presentations to the Department
of Medicine business meetings at both PHC and VGH
sites, and ongoing interaction with Division Heads at the
UBC Department of Medicine Division Heads meeting
held monthly and at the quarterly Subspecialty Program
Directors meetings. She has also presented to the core
internal medicine residents early in their academic year to
increase awareness of opportunities to pursue a research
career through the CIP.
The CIP director also provides advice and support to CIP
trainees as they negotiate their first faculty position and
provide referee letters for external funding.
One new initiative that is supported by the Department
of Medicine and the core Internal Medicine training
program is the opportunity for up to two core Internal
Medicine residents to pursue research training during their
residency. This initiative is also supported by the Faculty of
Medicine CIP and the director participates in the Faculty CIP
committee, which meets on a quarterly basis.
CIP goals for 2012-13:
• Prioritizing residents for selection into the core Internal
Medicine program who aspire to have research careers
and can be accommodated through the Core Internal
Medicine and Faculty CIP program.
• Continued formal and early contact with the core
Internal Medicine residents regarding career planning
and research via their Academic Half Day has occurred
regularly and in particular at the beginning of the
academic year.
• Ad hoc meetings with residents and fellows interested
in a research career
• Reviewing the applications from trainees in the
Department of Medicine to the Faculty of Medicinewide CIP competition to provide them with early
feedback and support.
EXPERIMENTAL MEDICINE
GRADUATE PROGRAM
•
Dr. Vincent Duronio
Professor & Director
Sciences)
Yu Yao (Dr. Theodore Steiner, Department of Medicine)
CIHR Master’s Scholarship were awarded to the following
students:
• Ganive Bhinder (Dr. Bruce Vallance, Department of
Pediatrics)
• Oksana Nemirovsky (Dr. Christopher Maxwell,
Department of Pediatrics)
• Eva So (Dr. Alice Mui, Department of Surgery)
• Jovian Wat (Dr. Edward Conway, Department of
Medicine)
Jacqueline Cragg (Dr. Matthew Ramer, Department of
Zoology) received a NSERC Postgraduate Scholarship.
PROGRAM OVERVIEW
The accomplishments that Experimental Medicine students
and supervisors achieved in 2012 are too numerous to list,
but below is a short summary of the major contributions.
The list consists of accomplishments that were self-reported
by students and faculty members and is therefore not
complete.
Taylor Drury (Dr. Darren Warburton, Department of Human
Kinetics) will receive the Governor General’s Gold Medal for
his Master’s thesis, which he defended in 2012.
William Guest (Dr. Neil Cashman, Department of Medicine)
who completed his MD/PhD program in 2012 will graduate
this May as the youngest MD/PhD student in the history
of UBC. He completed the PhD portion of his program in
Experimental Medicine in September 2011.
Awards
The students in our program are highly successful in
obtaining scholarships and awards from numerous
sources. The highlight in 2012 was that the Experimental
Medicine program was allowed to submit 5 nominations
to the UBC-wide Vanier Award competition and all of the
nominees were forwarded to the national competition in
Ottawa. At the national competition, UBC received 9 CIHRfunded Vanier scholarships and our program obtained 3
of them. The Vanier scholarships are valued at $150,000
each and are paid out over a period of three years. The
three Experimental Medicine students who received this
prestigious award are:
•
•
•
Anna Chudyk (Dr. Heather McKay, Department of
Orthopaedics)
David Knapp (Dr. Connie Eaves, Department of Medical
Genetics)
Malihe Poormasjedi Meibod (Dr. Aziz Ghahary,
Department of Surgery)
CIHR Doctoral Scholarship ($35,000 per year – for three
years) were also awarded in 2012 to the following students:
•
•
•
Jonathan Han (Dr. Megan Levings, Department of
Surgery)
Leon Lin (Dr. Xiaoyan Jiang, Department of Medical
Genetics)
Peter Raven (Dr. Michael Cox, Department of Urologic
Publications
A review of publications on PubMed indicated that in 2012,
our students published a total of 146 papers and 22 review
articles:
Published Papers
Total
146
First Author 52
Second Author42
Published Review Articles
Total
22
First Author 17
Second Author 5
This listing does not include abstracts and presentations at
conferences.
Aaron Phillips (Dr. Darren Warburton Department of Human
Kinetics) clearly stood out with 10 peer-reviewed papers
published in 2012; six of which had his name as 1st author.
Students’ Accomplishments:
Leigh Gabel (Dr. Heather Macdonald, Department of
Orthopedics) won the CIHR Institute of Musculoskeletal
Health & Arthritis Travel Award to ASBMR the institute’s
Annual Meeting as well as the ASBMR Young Investigator
76
Travel Grant to the Annual Meeting. She received the Best
Poster Award at the Child & Family Research Institute
Trainee Research Forum and was selected as one of 24
young researchers (national & international) to attend the
Canadian Obesity Network’s (CON) summer boot camp,
which comprises seven days of intensive training regarding
all aspects of obesity from epidemiology to cell biology,
metabolism, and clinical management.
Erin Macri (Dr. Karim Khan, Department of Family Practice)
spent five months at the University of Queensland, which
was funded through the Australian Endeavour Award
(Research Fellowship Award).
Ben Paylor (Dr. Fabio Rossi, Department of Medical
Genetics) was selected as one of 17 Canadians to receive
the 2012/2013 Action Canada fellowship.
He was also selected to participate in UBC President’s Blue
and Gold Revue, an annual celebration in excellence in
UBC’s faculty and staff. Additionally, Mr. Paylor won the
Public Outreach Award from the Stem Cell Network and the
People’s Choice and 3rd Place award at GeneScreenBC 2012.
Trina Stephens (Dr. Rajavel Elango, Department of
Pediatrics) won the UBC 3MT heat at the Child and Family
Research Institute on February 8th and was among the semi
finalists at the UBC-wide 3MT heat.
Vina Tan (Dr. Heather McKay, Department of Orthopedics)
presented a poster at the American Society for Bone and
Mineral Research and the poster was selected as a plenary
posters for the annual meeting. For more information,
please see:
http://www.asbmr.org/Meetings/AnnualMeeting/
AbstractDetail.aspx?aid=30627cf5-ea12-4709-8ecf63e9ca418ef2. Accessed March 22, 2012.
Joanna Triscott (Dr. Sandra Dunn, Department of Pediatrics)
received the “Mitacs Graduate Award for Outstanding
Research Achievement.” She was invited to Ottawa to
receive the award and had the honour to meet a number
of members of parliament and the senate. For more
information, please see http://www.mitacs.ca/n/2012/11/
outstanding-and-coming-researchers-honoured-2nd-annualmitacs-awards-reception
http://www.mitacs.ca/n/2012/12/award-winner-interviewjoanna-triscott
Asher Mendelson (Dr. Caigan Du, Urological Sciences)
received the Young Investigator Award from the Congress of
International Society for Peritoneal Dialysis.
Supervisors’ Accomplishments:
Dr. Antonio Avina-Zubieta is a recent Experimental
Medicine graduate who is now a faculty member in the
Department of Medicine. In 2012, he published seven
peer reviewed articles, three of which were published
in Annals of the Rheumatic Diseases, the leading journal
in the field of Rheumatology. Additionally, he presented
77
13 abstracts at national and international meetings, two
of which were podium presentations at The American
College of Rheumatology Meeting, the most important
meeting in the field. He also wrote a chapter for Dubois’
Lupus Erythematosus, considered the most significant
book in the field by Lupus scholars. Additionally, he acted
as reviewer for the Canadian Arthritis Network’s 2012
Fellowship Awards Competition and acted as juror for the
Pan-American League Against Rheumatism (PANLAR)’s 2012
PANLAR-ABBOT Prizes in Rheumatology.
Dr. Richard Harrigan (Department of Medicine) is the
Director of Research Laboratories at the BC Centre for
Excellence in HIV/AIDS. For more than a decade, Dr.
Harrigan has been a local, national, and international leader
in the development of cutting-edge translational research
with important implications for the clinical management of
HIV. He has contributed extensively to our understanding of
HIV drug efficacy and resistance, as well as the human and
viral parameters that influence HIV disease progression. His
lab has developed and distributed software for improved
automated analysis of HIV drug resistance (“ReCall”), which
is now being used worldwide. Dr. Harrigan’s research in
these areas has played a key role in enabling the significant
improvements in quality and duration of life afforded
patients by Highly Active Antiretroviral Therapy (HAART).
In July 2012, Dr. Harrigan was promoted to Professor.
Additionally, he received the UBC Faculty of Medicine
Distinguished Achievement Award and the ACCOLAIDS
2012: Living Positive BC. Science, Research and Technology
Award.
Dr. Darren Warburton (Department of Human
Kinetics) was recently awarded the prestigious CIHRCMAJ Top Achievements in Health Research Award.
Further information can be found at: http://www.
cihr-irsc.gc.ca/e/46457.html and http://www.cmaj.ca/
content/185/5/397.full.
Dr. Scott Garrison, another recent Ph.D. graduate of
Experimental Medicine, was appointed in 2012 as Medical
Director, Research for Vancouver Coastal Health in
Richmond.
P O S T G R A D U AT E E D U C A T I O N P R O G R A M
Dr. (James) Mark Roberts
Clinical Associate Professor and Director
The Residency Training Program in the Department of
Medicine is a provincially distributed program situated
at various sites throughout Vancouver and the lower
mainland including all major tertiary care facilities as well
as a number of allied institutions. In addition the training
program makes use of teaching opportunities in nontertiary care settings around the province.
The Program offers a curriculum of education and research
that stresses superb patient care as the key to excellent in
academic medicine. Trainees proceed under the guidance
and supervision of a faculty whose aims and outlook are
progressive and innovative.
Hazel Wilcox
Program Administrator
improve ACP exam results. The course consists of an
ACP question based video followed with a practice
exam and an opportunity to discuss any questions with
a Chief Medical Resident.
•
Introduction of a Feedback Program pilot in September
2012 . The pilot includes 9 PGY1”s and 3 faculty
members consisting of half day shadowing one on one
a few times a year as a vehicle to provide meaningful
formative feedback.
•
Investigation began into a Resident Wellness program
to focus resources on how best to aid our residents
with stress management. Dr. Roberts is working
with a life coach, Alycia Hall , to assist with a needs
assessment and recommendations on content focus /
delivery formats.
•
Promotion of Dr. Roger Wong to Associate Dean,
Postgraduate Education. Dr. Wendy Cook appointed the
new Associate Program Director and Dr. Jane McKay
appointed to the new position of Associate Program
Director PGY 4’s.
•
Completed majority of Accreditation Survey
documentation for submission to the PGME office in
January for the upcoming on-site visit planned for the
week of November 17th, 2013.
•
78
Established 2 CARMS positions at the Island Medical
Program (IMP) for the 2013-2014 academic year.
Worked in close collaboration with the Victoria
Site Director, Dr. Jim Spence, to ensure all program
deliverables and infrastructure were in place to enable
the successful application and selection of two site
based resident placements to begin their training July
1, 2013.
•
New community rotations started in Salmon Arm and
Campbell River.
•
Creation and Introduction of the Technology in
Medicine course for the 2012-2013 academic year.
There are 4 dates for the course and each PGY1 will
have one day of ultrasound and one day of simulation
training. Residents will be assessed during the course
and must pass the central line and LP.
•
Introduction of a MKSAP preparation course to
T H E U B C D E PA R T M E N T O F M E D I C I N E
I N T E R N A T I O N A L H E A LT H P R O J E C T
A partnership between the Internal Medicine Residency Training Program
& the Donald Fraser Hospital, Limpopo Province, South Africa
Alumni
We are proud of our alumni of 38 residents who went on
this elective, 20% of which have remained actively engaged
in global health undertakings. Four of the residents returned
as staff to lead a group.
Dr. Amanda Hill
History
This program has been functioning actively for 6 years.
We completed our five year commitment to Donald Fraser
Hospital and will be pursuing a MOU with Gulu University
Medical School in post conflict northern Uganda. Gulu
University has a long standing relationship with the
University of Manchester through the Uganda-UK alliance
and UBC will become part of this coalition.
Leaving Donald Fraser
Current plans
We are engaged this year in establishing a partnership
with Gulu University Medical School, McMaster University
and the University of Manchester. Gulu Medical School
is a new medical school which was established in 2004
in northern Uganda. The Medical School has graduated
3 classes (approximately 170 students) under deprived
and challenging circumstances. The north of Uganda is
recovering from 20 years of war which ended in 2008. 1.8
million people were living in internally displaced persons
camps and the countryside was devoid of people. The
conflict has resolved and people have returned to their
homes and there has been peace and growth in the region,
although it remains under-served and impoverished. The
relationship will have the following elements:
1.
Residency training: we will continue to send
residents for a clinical elective accompanied by a UBC
faculty member. We will send approximately 8 residents
per year. The residents will be engaged in clinical work,
teaching of medical students and clinical officers and will be
We sent 4 groups in 2012. The changes we witnessed in our
5 years there were as follows:
1. HAART roll out and HIV awareness had improved
exponentially with most patients having been tested and
agreeing to testing, and many patients successfully on longterm HAART.
2. The diabetic clinic was up and running and from a 0%
compliance of HbA1C testing, the clinic was achieving above
80% compliance.
3. Physician staffing had improved dramatically with South
African trained doctors doing their community service
rotations there.
Residency training
Residents remain keen to participate and we have sent 44
residents since the program started. We are able to recruit
clinical and academic faculty to accompany the residents,
many of whom have been more than once. We will be
formally investigating the residents’ learning by applying
a Canmeds framework to the evaluation. Meanwhile,
the residents are evaluated for a community elective on
WebEval.
79
Dr. Hill and Professor Moro on the bank of the Nile
encouraged to look at quality improvement initiatives that
are appropriate to the environment.
2.
The faculty will be appointed as visiting lecturers or
professors and will engage in teaching at the Gulu Medical
School. If the UBC faculty has the time and the interest, they
will be invited to deliver a course over the month, complete
with assessment. The faculty will also be responsible for
supervision and support of the UBC residents.
3.
In the long term, the Gulu University has requested
assistance in setting up an internal medicine masters equivalent to our residency program. This will be partnered
with McMaster University. There is still a lot of work to
be done to get this off the ground and we will assist as
requested.
4.
Partnerships: to increase sustainability and to
leverage our resources, we will collaborate with McMaster
University’s Department of Medicine and the University of
Manchester. Both of these institutions have a long history in
Uganda and have been a huge support to us in coordinating
and planning this work.
Networking at UBC
The Internal Medicine Global Health Program participates in
the Postgraduate Global Health Network which has proved
invaluable for networking and sharing evaluation tools and
pre-departure preparation. This network is a new initiative
and the Internal Medicine group has been instrumental
in getting it started. There is an attempt to coordinate
our global health undertakings within the Department
of Medicine as well and we are actively engaged in that
process.
Acknowledgements
We appreciate the commitment of Drs. Graydon Meneilly,
Mark Roberts and Ms. Hazel Wilcox to this program. We
also acknowledge the clinical faculty who have participated
and volunteered a month of their time – Drs. Voyeur,
Weerasinghe, Peters, Chow, Háček, Reid, Ambler, Skalska
and Suttcliffe. Drs. Steiner, Shapiro, Bowie and Steinbrecher
have all contributed their time and energy into this project.
Profiles of Alumni
Dr. Katherine Plewes has
a CIP award and is pursuing her PhD through Oxford
working with the Wellcome
Trust Mahidol-Oxford Tropical Medicine Research Unit
in Thailand, looking at the
effect of Paracetamol on
oxidative stress and renal
function in severe falciparum malaria.
Dr. Marla McKnight (right) has a Masters in Global Health from
Harvard. She is currently working in Kigali in a 7 year project
sponsored by USAID to scale up healthcare training in Rwanda
as a Harvard faculty member.
Dr. Katherine Chow (left) is one of 4 alumni who have lead
teams. She is pictured in Gulu with the first team from UBC in
Gulu in 2013, picking up lunch at the corner store.
80
U N D E R G R A D U AT E E D U C A T I O N P R O G R A M
Program Director
Kathy Standeven
Program Manager
*until October 2012
The Department of Medicine Undergraduate Education
Program Office is located in the Gordon and Leslie Diamond
Health Care Centre. The Department currently consists of
17 divisions: AIDS, Allergy and Immunology, Cardiology,
Community General Internal Medicine, Critical Care,
Endocrinology, Gastroenterology, Geriatric Medicine,
General Internal Medicine, Hematology, Infectious Diseases,
Medical Oncology, Nephrology, Neurology, Physical
Medicine & Rehabilitation, Respiratory Medicine and
Rheumatology. All Divisions are engaged in undergraduate
teaching.
The Department of Medicine Undergraduate Medical
Education Program is a distributed program with satellite
offices in Chilliwack (Chilliwack Integrated Clerkship), Prince
George (Northern Medical Program (NMP), and Victoria
(Island Medical Program (IMP). The IMP and NMP have 29
and 32 medical students respectively in the Undergraduate
Education Program. In preparation for the Southern
Medical Program (SMP) clerkship year in 2013, 16 students
are onsite in 2012 to complete a prototypical year.
• Review of Academic Half Day sessions with the intent to
recommend curriculum changes to improve the relevancy
and educational value of this teaching block.
The program’s Special Project manager, Dr. L. Lo, completed
a review of the student evaluations and met with the
divisions to discuss their roles and topic content and
found overall the impression was that Academic Half Day
is important; that it standardized education across the
distributed sites and gives the students valuable exposure
to a variety of sub-specialties. The method of delivery by
video conference was highlighted as a less than optimal
learning medium. Further review is now on hold as Dr.
Lo will offer his expertise to assist with the integration
81
Paola Martens
Program Manager
*as of October 2012
discussions regarding Academic Half Days in the context
of the new clerkship models evolving within Curriculum
Renewal.
• The review of the reliability of the Yr. 3 Undergraduate
Clerkship assessment methods as recommended by the
DOM Education Task Force and subsequent revision of exam
formats if deemed necessary.
Data was collected and submitted to the Assessment Office
for analysis in the Spring of 2012. George Pachev, Director,
Educational Assessment Unit, conducted the analysis and
presented his reliability findings in September 2012. The
physical exam, ward assessment and NBME exam all proved
to have a high degree of reliability. However, the oral
case scenario exams illustrated a low level of reliability. In
response, the program Assessment Director, Dr. W. Cheung,
managed the task of soliciting, reviewing and creating
18 new Case Scenario exams incorporating the following
features to improve the level of reliability:
•
•
•
A change to a standard scale
A revision of relative mark weighting by question
significance
Criteria examples for examiners re: score setting
The new cases were introduced with Group A in October,
2012.
DISCIPLINE SITE SPECIFIC LEADERS ( D S S L )
Royal Columbian Hospital
Dr. Gerald Da Roza
Head of Medicine
Director of CTU, Postgraduate
Dr. David Shu
Director of CTU, Undergraduate
Medical Director, RCH Care Clinic
Dr. Emily Lai
Outpatient Teaching Clinic Mentor
MEMBERS
Clinical Professor
Dr. Victor Chan
Dr. Gerald Da Roza
Dr. Sean Keenan
Dr. Yasemin Arikan
Dr. Ken Atkinson
Dr. Matt Bernard
Dr. Gerardo Carpenito
Dr. Aaron Cass
Dr. Dale Clayton
Dr. Charles Constantine
Dr. Justin Cheung
Dr. Kennely Ho
Dr. Mohamud Karim
Dr. Julie Lee
Dr. Cassie Lin
Dr. John MacCarthy
Dr. Samir Malhotra
Dr. Sangita Malhotra
Dr. Sebouh Matossian
Dr. George Medvedev
Dr. Michael Noble
Dr. Peter O’Connor
Dr. Anne Priestman
Dr. Steve Reynolds
Dr. Daniel Schwartz
Dr. David Shu
Dr. Robert Starko
Dr. Shirley TorngDr. Clarissa
Wallace
Dr. Sheila Webster
Dr. Chris Wong
Clinical Instructor
Dr. Agnieszka Barts
Dr. Steve Blackie
Dr. Anibal Bohorquez
Dr. Melanie Brown
Dr. Preet Chahal
Dr. Jocelyn Chase
Dr. Eliott Chum
Dr. Henry Chung
Dr. Randy Chung
Dr. Maggie Constantine
Dr. Susan Cooper
Dr. Cori Gabana
Dr. Jen Klinke
Dr. Darin Krygier
Dr. Emily Lai
Dr. Anson Li
Dr. George Lam
Dr. Julian Lee
Dr. Nittin Reebye
Dr. Nidhi Sood
Dr. Bradford Strijack
In progress
Dr. Erin Blake
Dr. Tabassum Firoz
Dr. Brent Appleton
Associate Members
Dr. Michael Ramsden
Dr. Marguerite Stolar
Dr. Cathy Flanagan
Dr. Robert Rothwell
Department Overview
Royal Columbian Hospital serves as a tertiary/quaternary care
centre for Fraser Health Authority and is the primary Internal
Medicine teaching site within the health authority. The Department of Medicine at Royal Columbian Hospital comprises
of 11 divisions: General Medicine, Endocrinology, Respirology,
Gastroenterology, Nephrology, Infectious Diseases, Neurology,
Rehabilitation Medicine, Hematology, Oncology and Geriatrics.
In addition, the Division of Rheumatology provides consultative
services to the Department.
The Department currently has 46 active members who all have
appointments in the UBC Faculty of Medicine. Many members
are directly within or are associated with their respective UBC
subspecialty divisions. The Department continues to see significant growth.
Dr. Preet Chahal & Julian Lee have joined the Department as
the third and fourth Neurologists and have been instrumental in
expanding the Neurology consult service and teaching opportunities.
Dr. Jocelyn Chase has joined the Division of Geriatrics. As the inaugural RCH Chief Resident she brings experience and expertise
in teaching and administration.
ambulatory experience for third year UBC medical students on
their internal medicine rotation at RCH. Clinics include infectious
diseases, geriatrics, hypertension, endocrinology, respirology,
general internal medicine, and gastroenterology. Newly added
clinics include Rheumatology staffed by Dr. Brent Appleton and
Dermatology by Dr. Christina Han.
Teaching
Teaching continues to be a primary focus of the department. All
new hires have the expectation that teaching will be an important part of their career. The CTU continues to run with 5 full
teams comprised of Internal Medicine residents, residents from
other training programs and undergraduate medical students
both local and international. Formal teaching activities include: morning report, weekly Respirology rounds, case of the
week rounds, weekly Department of Medicine rounds, staff-led
physical exam sessions and special lectures on acid-base, ABG
interpretation, EKG reading and chest x-rays.
The CTU has had the fortune of having outstanding Chief Residents who all have made lasting and vital contributions for the
past year. Heartfelt thanks are extended to Dr. Amir Ahmadi and
Dr. Mikhyla Richards for their outstanding work in 2012. We
are looking forward to having our 2013 chief residents, Dr. Sina
Alipour and Dr. Tara Cessford continue in this tradition of excellence.
The Department provides a variety of sub-specialty electives not
only to Internal Medicine residents, but also to fellows, external
residents (such as Anesthesia and Family practice) and medical
students. The department also provides clinical education for all
Dr. Shaoyee Yao joins the Nephrology group after completing her undergraduate years as organized through Dr. David Shu. Rotafellowship in the University of Toronto and has a particular inter- tions are consistently ranked highly by the Internal Medicine
residents for their teaching value. The department would like
est in hemodialysis.
to express their appreciation for the support of Dr. Dale Stogryn
and the hard work of Sherry Hubick, Leila Bailey, Anna Esposito
Clinical Services
and Dominika Ziemczonek in the Medical Education office.
The Department of Medicine serves as the primary Internal
Medicine teaching site for Fraser Health Authority. There is
Drs. Clarissa Wallace and Dale Clayton are serving as Clinical
a five team CTU staffed by Internists and sub-specialists that
Advisors in the new Alternate Learning Community (ALC) Pilot
provide 24 hour inpatient coverage and consultative services.
Program at RCH. RCH is playing host to a new pilot project
We provide support for complex cases throughout the health
from the UBC Faculty of Medicine MD Undergraduate Program
authority and facilitate transfer of care if necessary
which is an integral part of the MD undergraduate curriculum
renewal process. The longer term plan involves delivery of the
As a department, the Divisions of Gastroenterology, Nephrology, Respirology and Endocrinology provide 24 hour consultative full medical school curriculum at more “distributed” sites (that
service to the hospital and the region. Neurology, Infectious Dis- is not primarily based at the Point Grey campus). Seven Year 1
ease, Hematology, Oncology, Rehabilitation Medicine, Rheuma- student volunteers from the Vancouver Fraser Medical Program
tology and Geriatrics provide limited call coverage and week-day are participating in the New Westminster ALC pilot this year.
They are receiving most of their education at Royal Columbian
consultative service.
Hospital and in the surrounding community. Drs. Wallace and
We have a number of services on site at RCH including in-centre Clayton are providing mentoring and guidance for the seven first
year students involved in the Pilot as well as providing feedback
dialysis, endoscopy, bronchoscopy, outpatient IV therapy and
to the program administration.
chemotherapy.
Dr. Dale Clayton has joined the Endocrinology group from
Dalhousie and brings a lot of experience and interest in both
administration and Medical education.
Research
Our GI division is the only one in the region that offers EUS
endoscopic ultrasound and pancreatic ERCP under the guidance
Dr. Gerald Da Roza is head of research for Fraser Health Nephrolof Dr. Justin Cheung.
ogy and is currently the principal investigator for the Fraser site
in a couple of industry sponsored International multi-centered
The Outpatient Teaching Clinic provides an internal medicine
83
randomized clinical trial.
Dr. Matt Bernard was awarded his Master’s in Health Administration from UBC in May 2012
Dr. Emily Lai - Medical Director, RCH Internal Medicine Outpatient Teaching Clinic
Dr. Chris Wong – Division Head, Fraser Health Infectious Diseases
Dr. Kennely Ho is involved in a number of clinical trials in stroke
prevention.
Dr. Justin Cheung – Division Head, Fraser Health Gastroenterology
Dr. Preet Chahal has presented on exome sequencing in motor
neuron syndrome at the 2012 International Symposium on ALS/ Future Directions
MND. He has also had work published on the role of neuromuscular ultrasound in the diagnosis of focal neuropathies in
The Department plans ongoing expansion to improve access to
Clinical Neurophysiology.
clinical services. The goal is to continue to recruit into a variety
of subspecialties such as, Oncology, Rheumatology, Neurology
Dr. Steve Reynolds and the critical care group are involved in
and General Medicine in order to provide the full spectrum of
numerous clinical trials under his guidance and leadership. He consultative services and expertise to the region.
has recently been awarded a CIHR grant for work with phrenic
nerve pacing.
One priority is to expand Neurology care in order to become an
acute stroke center that can provide thrombolysis at all hours.
Dr. Julie Lee, Dr. Agnieszka Barts and Dr. Jen Klinke are involved The department is also hoping to add a Dermatology consultain a multicentre Canadian randomized clinical trial, the MiTy
tive service.
study. It is looking at the use of metformin during pregnancy in
those with type 2 diabetes.
The department will continue to work to optimize the blend
of general internists and sub-specialists that cover CTU with a
Dr. Mike Noble is a participant in a number of clinical trials
goal to enhance the trainee’s experience and learning. We will
involving cancer care and chemotherapy.
continually strive to strengthen the already excellent collegial
relationship we have with the other Departments such as EmerDr. Anne Priestman is leading the Endocrinology group in 2
gency Medicine and Surgery and look for additional educational
phase III industry sponsored trials related to the treatment of
opportunities.
diabetes mellitus, the most recent of which involves insulin
infusion pumps in type II diabetes.
Special Honours & Awards
Dr. Gerald Da Roza received the Dr. Shelley Naiman award as
Dr. Firoz is involved in global maternal health. Her current
Teacher of the Year for 2012 awarded by the Internal Medicine
projects include designing data collection methods and tools
residents.
for a community level cluster randomized trial and developing
a community-specific maternal health risk profile. She is also
involved in maternal health projects with the WHO and the UN
Commission for Essential Commodities.
Administration
Department members have taken on significant administrative
roles both within the hospital as well as the Health Authority as
a whole.
Dr. Sean Keenan – Program Medical Director Critical Care, Fraser
Health Authority
Dr. Peter O’Connor – Program Medical Director Geriatrics, Fraser Health Authority
Dr. Daniel Schwartz – Program Medical Director Nephrology,
Fraser Health Authority
Dr. Gerald Da Roza – Head of Medicine, Royal Columbian Hospital; Division Head, Fraser Health Nephrology;
CTU Director, Postgraduate
Dr. David Shu – Division Head, Fraser Health Endocrinology;
CTU Director, Undergraduate
84
•
Island Medical Program
(no photo available)
Dr. Jim Spence, DSSL Internal
Medicine, CTU Director, Assistant
Program Director
•
•
The Island Medical Program is a distributed site for undergraduate medical education located in Victoria on the campus of the •
University of Victoria. After the first two pre-clinical years in the
•
IMP, students begin rotating through clinical experiences in all
the disciplines they study. The third year clinical experiences are
provided by the two hospitals in Victoria, the Royal Jubilee Hospital and Victoria General Hospital. Fourth year clinical electives
broaden the experience to other teaching hospitals on Vancouver Island, in Vancouver and beyond.
Drs. David McDonald, Doug Skinnider and Jesse Pewarchuk
Cardiology CTU/CCU/Ambulatory Clinic
Drs. Lyall Higginson, Eric Fretz, Richard Mildenberger, Malcolm Williams, David Kinloch, Anthony Della Siega, Elizabeth Swiggum, Tycho Vuurmans, Simon Robinson, Richard
Leather, Larry Sterns, Anthony Tang, Paul Novak, Dennis
Morgan, Randall Sochowski, Manjeet Mann and Kenneth
Yvorchuk
Endocrinology
Drs. David Miller, Richard Phillips, Andrei Moldoveanu
Neurology
Drs. Andrew Penn, Wayne Shtybel, Kristen Attwell-Pope,
Martin Sutton-Brown, Olinka Hrebicek, others
Oncology
Drs. Adrian Yee, Jason Hart, Helen Anderson, Sheila Souliere, Vanessa Bernstein, Andrew Attwell, Grant MacLean,
Nicol Macpherson, Kenneth Wilson, Sharon Allen, others
Rheumatology
Dr. Milton Baker
Infectious Disease
Drs. Wayne Ghesquiere and Eric Partlow
Northern Medical Pogram
Third year clerks receive their experience in Internal Medicine in
an eight week rotation that consists of 4 weeks on the Medical
CTU at RJH, 2 weeks on the Cardiology CTU at RJH and 2 weeks
of Medicine Ambulatory Clinics at VGH, private offices and the
BCCA building at RJH. Ambulatory Clinics include experiences in
General Internal Medicine, Endocrinology, Neurology and Oncology. DSSL for the Cardiology CTU is Dr. Eric Fretz. DSSL for the
Medical CTU and Ambulatory Clinics is Dr. Jim Spence.
The Medical and Cardiology CTUs both provide clinical experience, not only to third year clerks, but also to PGY-1 residents
from the Family Practice Program and a variety of Royal College
sub-specialty Programs (Anesthesia, Radiology, Dermatology,
OB/GYN, Radiation Oncology, Psychiatry, Military). Each CTU
team is lead by a senior resident (R2 or R3 Internal Medicine)
visiting each block from the core Internal Medicine program
in Vancouver. A few Junior Attendings (R4 Internal Medicine)
make their way here for blocks to oversee the Medical CTU
Dr. Paul Winwood DSSL for the
team. Cardiology training for Internal Medicine residents also
includes blocks in the CCU and the Ambulatory Cardiology clinic Department of Internal Medicine
Teaching Program, Northern Medical
at RJH. Other sub-specialties in Victoria are beginning to offer
Program
opportunities for postgraduate training, notably Rheumatology, Infectious Disease and Hematology/Oncology. Late in 2010
plans were being made to extend these opportunities for the
next academic year to blocks in Nephrology, Respirology and
OVERVIEW OF PROGRAM
Neurology.
The University Hospital of Northern BC (UHNBC) serves the
city of Prince George and is the Regional Hospital for Northern
Current teaching staff include:
BC. Consultation and in-patient care is provided by a variety
of medical subspecialties including a ten bed ICU. Specialist
• Medical CTU
services include a rapid access clinic, non-interventional cardiac
Drs. Jim Spence, Steve Sullivan, Laura Farrell, Pat Marshall, lab, pacemaker placement, echocardiography, dialysis units
Prija Manjoo, Brian Weinerman and Sue Taylor
across northern BC, neurophysiology, endoscopy and endoscopic
• General Internal Medicine at Victoria General Hospital
ultrasound, ERCP, bronchoscopy services and a diabetes clinic.
85
Developments in 2012 include: a multi-disciplinary heart
function clinic and cardiac rehab program and the opening of
the Centre for the North (Cancer Care) which includes state
of the art radiation oncology. New recruits to the department
during 2012 included a second ID specialist, an additional
general internist, two radiation oncologists and one medical
oncologist.
Developments planned for 2013 include: a rapid access to
consultative expertise (RACE) service for the north in cardiology,
expansion of ICU to include a 6 bed medical step down unit
and addition of EBUS (endobronchial ultrasound) to our
bronchoscopy service. Planned recruits during 2013 include a
hematologist, two additional neurologists, a third respirologist,
additional intensivists, an endocrinologist, a geriatrician and
additional medical oncologists.
available for students in the Multiple Sclerosis Clinic, Diabetes
Clinic, EMG/EEG and Cardiac Lab (Stress Tests).
Additional Internal Medicine elective blocks in General Internal
Medicine and other medical subspecialties are available to CC3
and CC4 students from the Northern Medical Program and to
visiting students from other medical schools.
The Formal Teaching Program for medical students includes the
following:
General Internal Medicine Rounds at UHNBC on a weekly
basis
2. Chief Medical Resident Teaching by Video conference twice
a week
3. Daily Morning Report led by CTU attending, off service
attending or senior resident
4. Bedside Teaching Session by off-service faculty member
twice weekly
5. Multi-disciplinary Oncology Rounds at Centre for the North
TEACHING PROGRAM
– weekly
6. Pharmacotherapy Seminars taught by the clinical
The Teaching Program in Internal Medicine started in 2005
pharmacist weekly
when the first Northern Medical Program students reached the
7. Internal Medicine Journal Club (monthly)
third year. It is now well established but continues to develop.
UHNBC has one medical CTU which at any time has four medical 8. VGH Grand Medical Rounds Teleconferenced monthly
9. Academic Half Day Teleconferenced from Vancouver weekly
students, one or two Family Practice Residents (R1), one
10. Hospital Wide Noon Rounds at UHNBC weekly
Senior Internal Medicine Resident (R2 or R3) and an Attending
11. Simulation Sessions and Bedside Ultrasound instruction
Internist. The CTU is supported by a Senior Pharmacist (and
every other week
often a pharmacy resident) who has time dedicated to teaching
12. Chief medical resident site visit provides additional teaching
and supporting medical students and Residents. A clinical
monthly
associate (family physician) is available one or more days per
week in a supportive role. A permanent clinical associate has
Teaching Program for Residents:
recently been hired and will join the CTU in September 2013
for full support on weekdays as well as a half day dedicated
Family Practice residents (R1) participate in an 8 week CTU
to outpatient follow-up for CTU patients. The CTU manages a
rotation and attend most of the teaching sessions available to
broad range of Internal Medicine conditions and usually cares
the medical students. They also have access to ambulatory care
for approximately 20 complex medical patients. Learners are
clinics in Internal Medicine. They are given the opportunity to
exposed to diverse and often very advanced pathology.
present medical grand rounds and have their own academic
half day and a half day clinic back in family practice each week.
A typical CTU day starts at 07:00 am with a post call handover
They have recently started ICU rotations at UHNBC since ICU
reviewing new patients with the Attending Internist. At 08:00
has run as a closed unit, providing excellent one to one teaching
am there is formal morning report with case based interactive
opportunities and procedural experience supported by an
teaching led by the faculty or the Senior Resident. Throughout
enthusiastic team of intensivists.
the rest of the day, students and Residents are given time to
follow their patients and learn procedures. A simulation centre
opened at UHNBC in 2011 in which we have piloted teaching for Senior Medical Residents (R2/R3) from UBC participate in CTU
on a 4 week block rotating basis. The Prince George rotation
the CTU team focusing on team working and acute scenarios.
This has been led and was further developed by Dr John Smith gives them a unique view into life as an internist in a Northern
during 2012 and students are now receiving regular simulation Community and the seniors provide valuable support and
teaching which has greatly contributed to the success of the
sessions and instruction in bedside ultrasound as part of their
Northern Medical Program. There is also an ambulatory care
CTU experience. The simulation centre will continue to be
rotation for R3 internal medicine residents with outpatient clinic
developed in 2013 as additional faculty receive training and
experience in general medicine and a variety of subspecialties.
clinical scenarios relevant to internal medicine are developed.
Teaching Program for Medical Students
CC3 Program: In addition to the inpatient CTU rotation
students spend 2 weeks doing Ambulatory Care. This includes
clinics in Internal Medicine, Respirology, Gastroenterology and
Rheumatology. This gives the students opportunity for oneon-one teaching and mentoring. Ambulatory clinics are also
86
1.
Junior Attending (R4) residents began rotating on CTU in Prince
George in 2012. Additional rotations for R4 residents are
planned for 2013 with hopes for expansion of the R4 rotation to
include a variety of specialty/procedural opportunities valuable
in te practice of internal medicine in a remote community
setting.
Electives are offered for all levels of learners including specialty
fellows. In 2012 visiting fellows included R4 GIM, Respirology,
Nephrology and ICU.
VGH
FACULTY RESEARCH AND ADMINISTRATION
•
•
•
Dr Jacqui Petterson is a stroke neurologist conducting
research on memory disorders as part of a major academic
position with UBC.
Drs Lowry, Smith and Winwood are involved in research of
developing shared care with family practitioners
Dr Paul Winwood is the Principal Investigator for a basic
science program studying the role of proteoglycans and
ADAMTS enzymes in liver fibrosis
Department Members:
Dr. Khalid Bashir (Internal Medicine / Nephrology)
Dr Christian Fibich (Oncology)
Dr Michael Buchanan (Internal Medicine/Rheumatology)
Dr. Lyle Daly (Neurology)
Dr. Fareen Din (Internal Medicine / Nephrology/Intensive Care)
Dr Sharla Olsen (Internal Medicine/ Respirology)
Dr. Haidar Hadi (Internal Medicine / Cardiology)
Dr. Abu Hamour (Internal Medicine / Infectious Diseases)
Dr. Colleen Hennessy (Internal Medicine / Cardiology)
Dr Amir Ilyas (Neurology)
Dr. Z. Iqbal (Internal Medicine)
Dr Amin Lakhani (Internal Medicine)
Dr. Robin Lowry (Internal Medicine / Nephrology)
Dr. Donald MacRitchie (Diabetes)
Dr. Firas Mansour (Internal Medicine / Cardiology)
Dr Michael Martindale (Dermatology)
Dr. Khalid Raza (Internal Medicine/ Infectious Disease)
Dr. Jacqueline Pettersen (Neurology)
Dr. Abid Saadeddin (Internal Medicine / Gastroenterology
Dr. John Smith (Internal Medicine / Respirology)
Dr. Paul Winwood (Internal Medicine / Gastroenterology)
Dr. Leila Keyvani (Gastroenterology)
87
Dr. Cary Cuncic, Discipline Site Specific Leader, 3rd year, VGH
Vancouver General Hospital is a tertiary care hospital in
Vancouver with approximately 130 internal medicine patients
admitted at any given time. The Ambulatory outpatient internal
medicine department is located across the street at the Gordon
and Leslie Diamond Health Care Centre. Third year MSIs spend
8 weeks during their internal medicine rotation, 6 of which are
on the wards at the hospital and 2 of which are in the outpatient
clinics.
Six Week Ward Rotation
During the 6 weeks in the hospital, clinical clerks are assigned
to a main ward team typically composed of an Internist /
Subspecialist, senior resident, two junior residents and another
clinical clerk. Dr. Iain McCormick is the CTU Director. There
are 4 main ward teams and we utilize a “drip - call “ system
where one person from each team is on call each night. The
main advantage is that the person post - call goes home early
to ensure adequate rest. Medical students are on call 1 in 5.
Medical students admit to their own teams and follow their
own patients over the course of the hospital stay. Learning
takes place primarily in the authentic clinical environment. Post
- call review of newly admitted patients takes place from 8 am
until 10 am, the students are given protected time until noon
to see their patients. Noon rounds then take place over lunch
where all residents and medical students discuss a case, then
afternoons are spent in other formal teaching sessions, rounding
on patients, or on academic half day. The Chief Medical
Resident (CMR) holds a lot of interactive teaching sessions with
the clinical clerks. A typical week for clinical clerks looks like
this:
Monday:
0745: Handover Rounds
0800: post call intake
1000: see patients
1200: Noon Report. (case presentation)
1315: MSI CMR teaching
Thursday:
1000: see patients
1300: MSI Academic half day
Tuesday:
1000: see patients
1200: Noon Report (case presentation)
1315: MSI ID teaching
1430: MSI CMR session
Friday:
0800 post-call intake
1000: see patients
1030: MSI professor rounds
1200: Noon specialty Rounds (eg. medical oncology, nephrology, endocrinology, etc.)
13:15: MSI CMR Teaching
Wednesday:
1000: see patients
As stated, a variety of general internists and sub-specialists staff During the ambulatory rotation students are primarily located
in the General Internal Medicine (GIM) clinic with a number of
the CTUs and are listed below:
teaching sessions and subspecialty clinics as well. A Typical two
week Ambulatory block looks like this:
Dr. J. Busser
Dr. G. Meneilly
Dr. L. Chen
Dr. A. Nijar
Monday am: GIM
Dr. D. Collins
Dr. C. Reid
Monday pm: CMR Teaching Dr. Busser session
Dr. C. Cuncic
Dr. M. Roberts
Tuesday am: Cardiology
Dr. S. Das
Dr. D. Rosenbaum
Tuesday pm: Neurology Bedside Teaching
Dr. J. Kow
Dr. R. Reynolds
Wednesday am: Oncology
Dr. A. Kilber
Dr. M. Schacter
Wednesday pm: Stroke Clinic
Dr. R. Kherani
Dr. U. Skalska
Thursday am: GIM
Dr. E. Lai
Dr. S. Sutcliffe
Thursday pm: AHD
Dr. H. Nagi
Dr. P. Tam
Friday am: GIM
Dr. I. Mackie
Dr. D. Villanyi
Friday pm: CMR Teaching Dr. Busser; wrap-up
Dr. K. Madden
Dr. R. Wakefield
Dr. N. Mahmoudi
Dr. P. Weerasinghe
The Ambulatory clinics are supervised by a number of different
Dr. I. McCormick
Dr. S. Wong
general internists and internal medicine subspecialists.
Two Week Ambulatory Rotation
The two weeks of ambulatory medicine occurs during the 8
week block and students return to their same hospital ward
teams if the two weeks occurs in the middle. Students are
excused from call for these two weeks so that they may focus
on ambulatory medicine. Dr. Jim Busser is the Ambulatory
block mentor and meets with the students twice per week for
teaching, reflection and wrap - up. As well, one night until 10
pm during the ambulatory block, the MSI works alongside a
clinical associate (typically a senior medical resident) to answer
calls from the medical wards. These nights with the CA are
very well received, as students have the oportunity to assess
acute clinical presentations such as chest pain, shortness of
breath or GI bleeking while being supported 1:1 by the CA.
88
RESEARCH OFFICE
Teresa S.M. Tsang, MD, FRCPC, FACC, FASE
Associate Head Research
Meaghan Jones, PhD
Research Coordinator
In response to the needs and growth of the research
enterprise of the Department of Medicine, as articulated and
summarized in the documents developed by the Research
Task Force and external review process, the Research
Office was established in late 2011 to address issues and
impediments in research processes through creation of a new
infrastructure to enhance the research experience within all
levels of the Department.
role in the implementation of the recommendations of the
Research Task Force and the external review of research, and
develop other initiatives to advance the research mission of
the Department.
Our mission is to strengthen, invest, promote, and safeguard
the research enterprise within the Department of Medicine.
Our goal is to support and advance research, scholarship,
and innovation within the Department to achieve a position
as a preeminent research centre. The Research Office aims
to provide service to the Department of Medicine research
community that is responsive, effective, and proactive.
We are developing and cultivating relationships across the
university, with funding agencies, and within the department
across disciplines. We aim to identify the needs and develop
strategies to provide system and process improvements to
enhance research efficiency. We strive to develop a new
research culture that emphasizes collaboration, sharing of
knowledge and skills, interaction, and fun in knowledge
creation. We are committed to celebrate successes in
research and scholarship and to publicize these internally and
externally.
Dr. Teresa Tsang was appointed Associate Head, Research in
September 2011. She is a Professor of Medicine within the
Division of Cardiology with expertise in echocardiography and
clinical epidemiology. She was recruited to the Department of
Medicine in late 2009 from the Mayo Clinic, Rochester, MN.
She is internationally recognized for her research in atrial
fibrillation; echocardiographic prediction and prevention of
first atrial fibrillation, heart failure, stroke; atrial remodeling
and reversal; and diastolic function. In her capacity as
Associate Head Research, Dr. Tsang will oversee the strategic
operations of the Research Office, and take the leadership
89
Dr. Meaghan Jones is a PhD scientist in the field of Medical
Genetics. Through her work within the Department of
Medical Genetics, UBC and the Life Sciences Institute, she has
garnered expertise in grant development, ethics applications,
and scientific reporting. Working closely with Dr. Tsang, Dr.
Jones will play a key role in the day-to-day operations of the
Research Office to achieve the mission and vision for research
enterprise within the Department of Medicine, through the
development of a
cohesive, goal oriented scientific community that emphasizes
efficiency, collegial collaboration, and teamwork.
In 2012 the Research Office established a Research Advisory
Committee (RAC) to advise the Departmental Executive
on research priorities that support and advance research,
scholarship, and innovation within the Department, and
to continue to enhance the DOM’s status as a preeminent
research department. To this end, the RAC will serve as a
pool of highly qualified individuals with both experience
and an interest in supporting research. The RAC is chaired
by Dr. Tsang and its members are directors of research from
each division, departmental Research Coordinator, Head of
Experimental Medicine Graduate Program, and one senior
research coordinator or technician from one of our divisions.
The first annual departmental Research Expo was held in
2012. This event brings together members active in research
within the DOM for collective networking, idea sharing, and
collaboration. The event features a series of talks by DoM
members and a networking session. From this session a
number of collaborations have already been formed and in
general the event was very well received by participants.
CANADA RESEARCH CHAIRS, ENDOWED CHAIRS
& PROFESSORSHIPS
CANADA RESEARCH CHAIRS
Canada Research Chair in Chronic Obstructive
Pulmonary Disease (COPD)
Dr. Don Sin, Professor
In 2012, we continued our pursuit to discover molecular
pathways that lead to chronic obstructive pulmonary
disease (COPD). Towards this end, we collaborated with
investigators at Laval University, Mount Sinai School of
Medicine, Groningen University in the Netherlands, and
Merck Frosst and determined genetic variations that lead
to mRNA changes in lungs of over 1,200 smokers. This
powerful database, which integrates genome wide DNA
polymorphisms with gene expression changes within the
same lungs, will enable us to determine expression
quantitative trait loci (eQTLs) for asthma and COPD, which
in turn will lead to the discovery of lung biomarkers and
druggable targets to reduce the burden of these chronic
inflammatory lung conditions 1.
The eQTL information has already enabled us to identify the
causal gene responsible for asthma and to ascertain molecular
signatures of smoking in patients with COPD 1,2. We also
collaborated with investigators from Johns Hopkins University
and performed a genome wide association study of over 4,000
patients with mild to moderate COPD who participated in
the Lung Health Study (LHS). We found two new loci that
were associated with rapid progression of disease 3.
Importantly, this work has enabled collaboration with
geneticists in other genetic consortia to address large scale
genetic questions, which have led to new insights on the
“origins” of human protein coding variants4, genetic
determinants of thoracic aortic aneurysms and dissections 5,
90
and genetic modifiers of cystic fibrosis6.
In 2012, we also continued our work in finding biomarkers
for COPD. Using the LHS cohort, Jee Lee, a master’s student in
my lab, determined that telomere lengths of peripheral
leukocytes were related to lung function and that short
telomeres were associated with increased risk of mortality
(and especially that related to cancer)7. These data suggested
that replicative senescence plays an important role in the
pathogenesis of COPD and that telomeres may be a promising
biomarker to track prognosis of these patients. As part of this
work, we also found that adiponectin, serum adipokine which
is produced largely by fat tissue, is associated with rapid
decline in lung function. Intriguingly, however, serum levels
were associated with reduced risk of cardiovascular disease8.
Thus, adiponectin appears to have a dual biomarker feature
in COPD: predicts COPD progression and cardiovascular
disease. We also extended our health economics work to
show the current and future financial burden of COPD
in Canada. This paper showed that the main drivers of
cost in COPD over the next 30 years will be COPD related
exacerbations and thus by reducing the risk of exacerbations
in COPD patients, we can substantially reduce the costs of
COPD care in Canada9. We also continued to explore
the relationship between COPD and cardiovascular
disease through a series of animal studies and human
experiments10-12. As part of CRC, I have involved my trainees
in projects and papers. To this end, Rachel Jen, a medical
resident at the time, conducted a nice systematic review
and wrote (and published) on the effects of inhaled
corticosteroids on lung inflammation13. Joanna Zurawaska,
a 4th year medical resident, wrote a review on the evidencebased approach to smokers with lung nodule14. Hye Yun
Park, a visiting scientist from Samsung Medical Center in
Korea, wrote a review paper on the use of inhaled
corticosteroids in COPD15. In addition to these publications,
CRC enabled training of 2 master’s students, 3 PhD students
and 2 post-doctoral fellows and successful receipt of a $7.2
million grant from Genome Canada/CIHR to expand our
biomarker program in COPD.
Hao K, Bosse Y, Nickle DC, et al. Lung eQTLs to help reveal
the molecular underpinnings of asthma. PLoS genetics
2012;8:e1003029.
2. Bosse Y, Postma DS, Sin DD, et al. Molecular signature
of smoking in human lung tissues. Cancer research
2012;72:3753-63.
3. Hansel NN, Ruczinski I, Rafaels N, et al. Genome-wide
study identifies two loci associated with lung function
decline in mild to moderate COPD. Human genetics
2013;132:79-90.
4. Fu W, O’Connor TD, Jun G, et al. Analysis of 6,515 exomes
reveals the recent origin of most human protein-coding
variants. Nature 2013;493:216-20.
5. Boileau C, Guo DC, Hanna N, et al. TGFB2 mutations
cause familial thoracic aortic aneurysms and dissections
associated with mild systemic features of Marfan
syndrome. Nature genetics 2012;44:916-21.
6. Emond MJ, Louie T, Emerson J, et al. Exome sequencing
of extreme phenotypes identifies DCTN4 as a modifier
of chronic Pseudomonas aeruginosa infection in cystic
fibrosis. Nature genetics 2012;44:886-9.
7. Lee J, Sandford AJ, Connett JE, et al. The relationship
between telomere length and mortality in chronic
obstructive pulmonary disease (COPD). PloS one
2012;7:e35567.
8. Yoon HI, Li Y, Man SF, et al. The complex relationship
of serum adiponectin to COPD outcomes COPD and
adiponectin. Chest 2012;142:893-99.
9. Najafzadeh M, Marra CA, Lynd LD, et al. Future impact of
various interventions on the burden of COPD in Canada: a
dynamic population model. PloS one 2012;7:e46746.
10. Man SF, Van Eeden S, Sin DD. Vascular risk in chronic
obstructive pulmonary disease: role of inflammation
and other mediators. The Canadian journal of cardiology
2012;28:653-61.
11. Miyata R, Bai N, Vincent R, Sin DD, Van Eeden SF. Novel
properties of statins: suppression of the systemic and
bone marrow responses induced by exposure to ambient
particulate matter (PM(10)) air pollution. American
journal of physiology Lung cellular and molecular
physiology 2012;303:L492-9.
12. Van Eeden S, Leipsic J, Paul Man SF, Sin DD. The
relationship between lung inflammation and
cardiovascular disease. American journal of respiratory
and critical care medicine 2012;186:11-6.
13. Jen R, Rennard SI, Sin DD. Effects of inhaled
corticosteroids on airway inflammation in chronic
obstructive pulmonary disease: a systematic review
and meta-analysis. International journal of chronic
obstructive pulmonary disease 2012;7:587-95.
14. Zurawska JH, Jen R, Lam S, Coxson HO, Leipsic J, Sin
DD. What to do when a smoker’s CT scan is “normal”?:
Implications for lung cancer screening. Chest
2012;141:1147-52.
15. Park HY, Man SF, Sin DD. Inhaled corticosteroids
for chronic obstructive pulmonary disease. Bmj
2012;345:e6843.
91
Canada Research Chair Tier I in Immunology
Dr. John Schrader, Professor
Universal influenza vaccine
We found a surprising observation that overturned 50 years of
influenza immunology and demonstrated that cross-protective
antibodies against broad influenza strains could be produced
by humans, either by infection with influenza or influenza
vaccination. We started in influenza research in the summer
of 2009 when the “swine H1N1 flu” was starting, becoming a
WHO-reported pandemic. We generated human monoclonal
antibodies from samples of blood from convalescent patients
who had recovered from infection with the 2009 H1N1
pandemic influenza virus or was vaccinated with the vaccine
made from pandemic H1N1 influenza. The pandemic H1N1
influenza vaccine was made by conventional methods using
the conventional template for seasonal influenza vaccine.
We soon realized that many of the monoclonal antibodies
had surprising properties and not only neutralized swine
flu, but also the highly pathogenic H5N1 bird flu. This was
unexpected and very useful for therapeutic purposes as
normally the antibodies induced by influenza infections or
vaccines are narrowly targeted and specific to a particular
strain of influenza. We discovered the mechanism through
which these unusual broad-spectrum anti-influenza antibodies
were induced, and now are working towards a much soughtafter, broad-spectrum vaccine against influenza. However,
this is only true when humans are infected or vaccinated with
the hemagglutinin (HA) from influenza virus not circulating
in humans, such as the HA of the Pandemic 2009 H1N1
influenza virus, which was circulating in swine. The paper
established that the cross-protective epitopes were exhibited
by conventional seasonal influenza vaccines and that crossprotective antibodies could be induced by the 2009 pandemic
H1N1 vaccine, which was made by conventional methods
used to manufacture the seasonal influenza vaccine. It was
also established that cross-protective, broadly neutralizing
antibodies against influenza were not detected by the WHO
neutralizing assay. We modified the assay so that cross-
protective antibodies could neutralize the influenza virus,
even avian H5N1.
Our manuscript showed that a conventional vaccine made
from an influenza virus not circulating in humans could
induce cross-protective antibodies. The paper was reviewed
over 2 years by Science, Nature Medicine and NEJM by three
reviewers for every journal.
I later found out that one reviewer for Nature Medicine,
Jonathan Yewdell, invited me to a Round Table at NIH to
discuss the ideas for a universal influenza vaccine in June 1920, 2012.
When the paper was published in Frontiers in Immunology
in May 2012, it got world-wide coverage. I was asked to
speak on the BBC, a science program in Germany and was
interviewed numerous times by radio and national TV news.
At the end of the last year, three journalists followed up, one
in a News and Views in Nature Medicine that was published
last December, one about to be appearing in The Scientist and
one about to be appearing in BBC’s science magazine Focus.
In January this year, a Frontiers editor wrote that our paper
received 3,757 total views, in 7 months, making it among
the highest-performing articles in Frontiers. They invited
me to serve as a Topic Editor of a Frontiers Research Topic, a
collection of papers selected to provide an encyclopedic, open
access snapshot of the current state of the art.
In 2012, we got a 5 year CIHR Operating Grant to work on a
better influenza vaccine.
Evolution of the human antibody response that protects us
against common pathogens
We have been generating human monoclonal antibodies that
protect against common viruses, Human Cytomegalovirus
(HCMV), or bacteria, Streptococcus pneumoniae, pathogens
that threaten human health. This was supported by a 5
year CIHR Operating Grant. We have found evidence that
evolutionary pressure has shaped our antibody genes to
ensure that we rapidly make protective antibodies against
vulnerable sites on common pathogens. In particular
both human protective antibodies against HCMV and S.
pneumoniae use a common immunoglobulin V-gene pair of
H and L chain of antibodies, IGHV3-30 and IGKV3-11. We
worked a crystallographer collaborator with another Tier 1
CRC, Dr Emil Pai, University of Toronto, to solve the three
complexes of a Fab fragment of 023.102, a high-affinity
protective human monoclonal antibody against the S.
pneumoniae that targeted a carbohydrate called 23F, with
(1) L-rhamnose, (2) methyl--L-rhamnopyranosyl-(12)--Dgalactopyranoside (RG) and (3) methyl--L-rhamnopyranosyl(12)-3-(glycer-2-yl-phosphate)--D-galactopyranoside (RGP).
The three carbohydrates all form part of the subunit of 23F.
We solved another complex of Fab fragment that used IGHV330 and IGKV3-11 of a high-affinity human monoclonal that
neutralized HCMV, KE5, with its target epitope a peptide, AD2. The structure of 102 shows how germline residues shape a
cavity for L-rhamnose. A comparison of structural features of
complexes of the two protective antibodies against HCMV and
S. pneumoniae showed how stochastically encoded CDRH3
92
and CDRL3 have a different structure that reorientates the
germline residues to shape two very different binding sites
binding to a peptide and a carbohydrate. Germline Trp94(L)
contacts both the peptide and carbohydrate epitopes and the
four complexes shows how a stochastically encoded CDRL3,
puts the germline residue, a Trp94(L), in a proper orientation
to interact with the L-rhamnose or interact with the AD2S1. Thus one residue encoded by germline IGKV-3-11, can
multitask with different stochastically encoded CDR3’s to bind
to very different epitopes. We have prepared a manuscript
that we are submitting to PNAS.
A candidate therapeutic monoclonal antibody to treat
rheumatoid arthritis and multiple sclerosis and cancer Our
laboratory performed a genetic and functional analysis of
pathogenic human monoclonal autoantibodies against the
hemopoietic growth factor or cytokine termed granulocyte
macrophage colony-stimulating factor (GM-CSF). GM-CSF
stimulates the proliferation and differentiation of committed
progenitors that generate neutrophils, macrophages and
dendritic cells and also activates the differentiated effector
cells like macrophage to increase their activity and live
longer. Preclinical experiments suggest that neutralizing the
bioactivity of GM-CSF with an antibody can help in animal
models of arthritis, multiple sclerosis or pain or cancer. We
have generated a truly human monoclonal antibody against
GM-CSF that neutralizes GM-CSF bioactivity at very small
concentrations and is ready for clinical testing. We have
collaborated in this project with Australians in Melbourne
and Adelaide and we have collaborated with the University
of Toronto. Our first analysis of pathogenic autoantibodies
against cytokines has been accepted in PNAS.
M-Ras a molecular switch that is triggered by many stimuli in
cells and the involvement in cancer and other human diseases
This study is supported by a 5 year CIHR Operating Grant.
Mice lacking functional M-Ras genes are viable and fertile. As
well, mice lacking functional M-Ras genes perform better in
tests where they need to remember where food is hidden. We
have also found that male mice lacking M-Ras are aggressive,
and have seen some interesting changes as the mice age; the
aged males exhibit distended bladders and the aged females
show signs of depression. We have tested whether mice
lacking M-Ras are less likely to get a leukemia caused by an
oncogene. Our preliminary results indicate that they are less
susceptible to leukemia.
We also tested C. elegans lacking M-Ras. We tested our
hypothesis that activated p21 Ras or activated tyrosine
kinase receptors in C. elegans did not produce abnormalities
in worms lacking M-Ras. There was no difference in the
abnormalities of worms that had that activated p21 Ras or
activated tyrosine kinase receptors in worms lacking M-Ras
or worms with M-Ras. However, we need to check whether
M-Ras in C. elegans is in the same location as mammalian
M-Ras.
New techniques to develop monoclonal antibodies
We have collaborated in the past with physicist Dr. Carl
Hansen through a CHRP grant from CIHR and NSERC to
develop a new way of generating monoclonal antibodies on a
small chip using microfluidics. The project is doing well. We
have got support in 2012 from a CIHR Proof of Principle Grant,
and I2I from NSERC and a large grant from Genome BC to
commercialize our technology into a local spinoff company.
Canada Research Chair in Neuroethics
Dr. Judy Illes, Professor
Canada Research Chair in Neurodegeneration and
Protein Misfolding Diseases
Dr. Neil Cashman, Professor
Dr. Cashman was appointed Canada Research Chair in
Neurodegeneration and Protein Misfolding Diseases at the
University of British Columbia in 2005, and this appointment
was renewed in 2011. He studies “protein only” infectivity
of prions, driven by template-directed misfolding of the
normal cellular prion protein (PrPC) by physical contact
with the abnormal, disease-specific prion protein (PrPSc).
Template-directed protein misfolding also participates in
other neurodegenerative syndromes, including Alzheimer’s
disease, amyotrophic lateral sclerosis (ALS), and Parkinson’s
disease. Dr. Cashman published a landmark paper in 2011
in PNAS on intermolecular interactions that convert normal
Cu/Zn superoxide dismutase (SOD1) to an aggregated and
propagating form. Central programs in the lab include the
development of immunotherapies for ALS and Alzheimer’s
disease, which have been licensed by Biogen-Idec Corp in
2011, and Cangene Corp in 2012, respectively. In 2012, the
Cashman lab was also granted two US patents, and held
grants from PrioNet Canada, CIHR, and from industry. In 2012,
he was recognized by Life Sciences BC with the Genome BC
Award for Scientific Excellence. From 2005-2012, Dr. Cashman
has led PrioNet Canada as Scientific Director of this Network
of Centres of Excellence. He has also served as Chief Scientific
Officer of Amorfix Life Sciences in Toronto, and Academic
Director of the ALS Centre at GF Strong Hospital. He provides
teaching and mentoring for neurology trainees in the UBC
Medical School and Vancouver General Hospital, as well as 3
current graduate students in his laboratory.
93
Dr. Judy Illes was appointed Canada Research Chair in
Neuroethics and Professor of Neurology in the Department
of Medicine in August 2007. With the generous support of
the Chairs program, CIHR/INMHA, the Canadian Foundation
for Innovation, the British Columbia Knowledge Development
Fund and other research sponsors, she established the
National Core for Neuroethics at the University of British
Columbia, the only national research resource in the world
in the area of neuroethics. Dr. Illes and her team are devoted
to the ethical translation of neurotechnology toward the
promotion of brain health and wellness, and the advancement
of improved methods for diagnosis, prediction and treatment
of brain diseases in the clinic and consumer marketplace.
Dr. Illes highlights the following selected accomplishments of
the past year:
•
Major individual distinctions recognizing scholarly
accomplishments and contributions, including election as a
Fellow of the Royal Society of Canada, Division of Life Sciences
•
Ongoing leadership of the International Neuroethics
Society, and service to the US-Canada Regional Committee
for the International Brain Research Organization (IBRO),
Women in World Neuroscience (IBRO), the Stem Cell Network,
the Peter Wall Institute of Advanced Studies International
Academic Advisory Committee, and various academic UBC
committees.
•
New grants in neuroimaging (CIHR): Neuroimaging for
Disorders of Consciousness – Charting the Canadian Ethics
Landscape; in stem cells (Stem Cell Network): Translation
Challenges, Science Policy, and Stem Cell Research; and
in neurodevelopmental disorders (Peter Wall Institute for
Advanced Studies): Deliberations on the Ethical Use of
Antipsychotic Medications in Children.

Outstanding new fellows and students recruited to the
Core, and movement of other graduate and alumni to new,
top-choice academic positions. One postdoctoral fellow has
received a faculty appointment and is being advanced as a
Canada Research Chair (Tier II) in Community-Engaged Health
Research. An outstanding Masters student began his law
studies at Stanford University.

New publications with Residents in Neurology and
continued growth Clinical Neuroethics programs.

More than a dozen peer-reviewed manuscripts,
including papers in high impact journals such as Nature
Biotechnology, Genetics in Medicine, and Sociology and
Health.
•
Major lectures, invited presentations, and conference
leadership and participation worldwide. In June 2012, Dr.
Illes gave the Margarete Wuensche Memorial Lecture at the
Hotchkiss Brain Institute at the University of Calgary.

Significant public outreach and frequent appearances
and commentary in the press, and on radio and television.
In October 2012, Dr. Illes was featured in Science for her
leadership to harmonize NIH and CIHR guidance on the
management of unexpected clinical findings in brain imaging
research.
The major goal for the next year: transitioning establishment
grant funding into large-scale support as national centre of
excellence that ensure the stability and continued growth of
the Core and its contributions to neuroethics worldwide.
Dr. Illes gratefully acknowledges co-leadership of the Core
and Core projects by Professor Peter Reiner (Psychiatry) and
Dr. B. Lynn Beattie (Geriatrics), and recognizes Core Faculty
Affiliates, distinguished advisors, and collaborators across the
UBC campus, Canada and internationally.
Dr. Illes’ research and the current activities of the Core
are made possible by generous support from the Institute
of Neurosciences, Mental Health and Addiction (INMHA)
of the Canadian Institutes of Health Research (CIHR), the
National Institute of Aborginal Peoples’ Health (CIHR), the
Canada Foundation for Innovation (CFI), the British Columbia
Knowledge Development Foundation (BCKDF), the National
Institutes of Health (NIH/NIMH), the Vancouver Coastal Health
Research Institute (VCHRI), the Stem Cell Network (SCN),
the Foundation for Ethics and Technology, GenomeBC, the
Canadian National Centres of Excellence, the North Growth
Foundation, and the Dana Foundation.
Canada Research Chair for Neuropsychology of
Vision and Eye Movements
Dr. Jason Barton, Professor
Dr. Barton was appointed a Canada Research Chair in 2004. His
Human Vision and Eye Movement Laboratory investigates how
cerebral cortex performs complex levels of visual processing
and implements control of saccadic eye movements. To do
this the lab studies both healthy subjects and patients with
damage to certain brain systems, using both assessments of
behaviour and also functional neuroimaging.
A major focus of the laboratory is understanding how the
human visual system performs high-level object recognition.
A substantial portion of this work concentrates on face
processing. The laboratory has pioneered the use of novel
techniques in studying face adaptation, which probes the
nature of mental representations of faces. It is also engaged
in a long-term international collaborative project on
prosopagnosia, a condition in which subjects lose the ability
to recognize faces. The group has a CIHR-funded program to
fly subjects with this rare condition to Vancouver for detailed
functional MRI, EEG and perceptual studies, to elucidate
the relationship between patterns of dysfunction and the
structural damage in cerebral cortex. This year the work on
prosopagnosia has turned to the development and study
of perceptual learning paradigms, to determine whether
extensive training has any potential in the rehabilitation of the
face recognition deficits of these patients.
Their work on high-level object recognition has also turned
to the study of visual word perception, an acquired expertise
that engages the left occipital cortex, with parallel studies
using adaptation and patients with alexia. In addition, a
new focus has been to apply perceptual learning as a novel
approach to improving hemianopic dyslexia, the reading
difficulty suffered by patients with loss of vision in the right
half of their world.
In eye movement research, the laboratory has continued work
on modulatory influences on behaviour, such as distractors,
94
foreknowledge, prior history and future expectations. Using
a simple response like a saccade enables researchers to
precisely characterize these important effects on cognition,
which may serve as optimizing factors to enhance our
behavioural responses to the world.
The laboratory has expanded into the realm of neuroeconomics, borrowing traditional methods used to study
perception of visual stimuli to study how humans perceive
cognitive variables such as magnitude of reward or loss
and the probability of outcomes. It has recently created
the Vancouver battery of decision-making, which uses
prospect theory to analyze and isolate five different cognitive
operations involved in the assessment of economic risk, and
which will be applied to the study of patients with Parkinson’s
disease.
Overall, in 2012 the group had 14 research presentations, 12
peer-reviewed publications, 18 invited talks, and published
7 chapters or invited commentaries. Dr. Barton was also
appointed the Marianne Koerner Chair In Brain Diseases.
of families with dominantly inherited disease, as part of an
international collaboration with investigators from Mayo
Clinic Jacksonville, University of Washington, Norway and
Japan. These studies have demonstrated abnormal dopamine
turnover and release in clinically unaffected mutation carriers,
many years prior to expected disease onset, and prior to
other functional abnormalities in dopaminergic function.
Additionally, the studies demonstrate that the trajectory of
dopamine denervation in mutation carriers agrees well with
a model derived from patients with established sporadic PD.
These observations validate the extrapolated exponential
function derived from mathematically modeling the data
obtained in established PD, and support the study of
asymptomatic mutation carriers to understand the evolution
of preclinical disease (and ultimately to assess the effects
of disease modifying therapies). PPRC investigators work
closely with Dr. Matt Farrer, Canada Excellence in Research
Chair in Neurogenetics and Translational Neuroscience,
and internationally renowned expert in the genetics of PD.
In collaboration with investigators in the Departments of
Psychiatry and Psychology, PPRC investigators continue to
study the basis for depression and impulse control disorders in
Parkinson’s and during 2012, initiated collaborations to study
the basis for the benefits of exercise in PD.
In addition to these activities, Dr. Stoessl served on the
Editorial Boards of Annals of Neurology, Lancet Neurology,
Parkinsonism & Related Disorders and Translational
Neurodegeneration and the Clinical Scientific Advisory Board
of the National Parkinson Foundation. He chaired the Awards
Committee of the Movement Disorders Society and the
Mentorship Committee of the Parkinson Study Group. He sat
on the International Executive Committee of the Movement
Disorders Society, as a Councillor for the International
Association of Parkinsonism & Related Disorders and cochaired the Steering Committee for the next World Parkinson
Congress (Montreal, 2013).
Canada Research Chair in Parkinson’s Disease
Dr. A. Jon Stoessl, Professor
Dr. Stoessl was originally appointed a Tier 1 Canada Research
Chair in 2000 and successfully renewed his Chair in 2007. Dr.
Stoessl is Head of the Division of Neurology and directs the
Pacific Parkinson’s Research Centre and National Parkinson
Foundation Center of Excellence at UBC. In 2012, he continued
to direct a Pacific Alzheimer Research Foundation Team
on Overlap Syndromes resulting in Dementia. The team’s
research program uses functional imaging to study the
progression of Parkinson’s disease (PD) and other related
Canada Research Chair in Neuroepidemiology and
disorders, the basis for complications of advanced disease
Multiple Sclerosis
and its treatment, as well as the use of PD as a model to
better understand the role of dopamine in the healthy
Dr. Helen Tremlett, Associate Professor
brain. In 2012, team members continued their work on
longitudinal studies conducted in asymptomatic members
95
Canada has some of the world’s highest rates of multiple
sclerosis (MS). Every day three more Canadians are diagnosed
with this devastating disease for which there is no known
cure. The brain and spinal cord are attacked by the body’s
own immune system, leading to numbness and tingling,
severe fatigue, coordination problems and potentially the
need for walking aids or a wheelchair. MS is one of the leading
causes of disability in young Canadian adults. Despite this, it
is not known what drives or influences disease progression
in MS. If specific factors could be identified, then this could
dramatically improve outcomes for people with MS and
perhaps prevent disability from occurring.
The research goals of Dr. Helen Tremlett, Canada Research
Chair in Neuroepidemiology and Multiple Sclerosis, are
to investigate possible underlying factors driving disease
progression – from genes to the environment. Dr. Tremlett is
also investigating whether the current MS drugs affect disease
progression by examining their long-term impact on disability
and balancing any beneficial effects against drug safety.
Together these initiatives will lead to a more individualized
approach to care in MS. A core component of this program
will focus on bringing together, for the first time, multiple
large health and clinical databases created for over two
decades. In addition, experts from a wide range of disciplines,
including genomics, environmental geography, epidemiology,
drug safety, statistics and neurology will collaborate to form a
truly multi-disciplinary approach to MS research. Ultimately,
this research aims to improve the health, treatment options
and outcomes for people living with MS. Dr. Helen Tremlett
heads the Pharmacoepidemiology in MS (PiMS) Research
group which includes an 18 strong dedicated team of
trainees, fellows and post-docs from diverse backgrounds
such as pharmacy, medicine, epidemiology, genomics and
biostatistics. Highlights from 2012 include completion and
publication of a study in the Journal of the American Medical
Association (impact factor = 30, 3rd top ranking medical
journal worldwide, lead author Afsaneh Shirani) in which
we found no strong association between exposure to one of
the commonly used drugs to treat MS, the beta-interferons,
and disability progression. The study provides patients and
physicians with more realistic expectations as to the potential
long-term benefits of these drugs. This research was selected
by the journal for a special press-release and media coverage
included CTV and The New York Times. Dr. Tremlett’s research
efforts are generously funded through CIHR, the MS Society of
Canada, the US National MS Society, the UK MS Trust and the
Martha Piper Fund.
96
Canada Research Chair Tier 1 in Endothelial Cell
Biology
Dr. Edward M. Conway, Professor
Dr. Conway repatriated from the University of Leuven,
Belgium in 2009, whereupon he was appointed a Canada
Research Chair in Endothelial Cell Biology at the University
of British Columbia, where he is also the director of the
Centre for Blood Research. His research program is focused
on characterizing the molecular links between pathways that
control blood clotting and inflammation, and elucidating the
protective properties of cells that line the inner aspect of
blood vessels (endothelial and stromal cells).
Throughout evolution, organisms have developed means to
simultaneously contain wounds by limiting bleeding with clot
formation and fighting pathogens, thereby enabling rapid
healing. Disease emerges when there is unchecked activation
of the innate immune and/or coagulation responses.
Simultaneous excess coagulation and complement activation
(a component of the innate immune response) are evident in
numerous diseases, including, for example, atherosclerosis,
stroke, coronary heart disease and diabetes, as well as organ
ischemia-reperfusion, the metabolic syndrome, and other
similarly serious disorders, such as age-related macular
degeneration and hemolytic-uremic syndrome. With the
discovery by several groups, including Dr. Conway’s, that
common molecular mechanisms regulate coagulation and
inflammation, the last decades have seen major progress in
identifying the cellular and molecular links. However, there
remain major gaps and new discoveries are urgently needed
for the development of novel strategies to prevent and/or
treat these diseases.
In the past year, Dr. Conway’s research team has uncovered
several previously unrecognized proteolytic pathways that
challenge decades of dogma. His group has determined that
the central coagulation enzyme, thrombin, directly cleaves
and activates a key complement component, C5, generating
previously undescribed, but more potent biologically active
protein complexes. His team has also determined that the
major enzyme that dissolve blood clots also degrades a
complement component, the fragments of which facilitate
leukocyte clearance of invading pathogens. Finally, in work
to be presented at the International Society of Thrombosis
and Hemostasis, students in Dr. Conway’s lab have identified
an entirely new regulatory pathway to dampen activation
of the complement system. These findings uncover new
paradigms that may be exploited for the development of novel
therapeutic strategies and diagnostic approaches for multiple
inflammatory, thrombotic and malignant disorders.
Dr. Conway’s group is also exploring the role of the protein,
CD248, that is highly expressed by so-called “perivascular
cells” that surround blood vessels. Interestingly, this multidomain glycoprotein is only expressed under pathologic
conditions, i.e. during inflammation (e.g. arthritis) and cancer.
Most intriguing is Dr. Conway’s finding that mice that lack
CD248 are relatively resistant to developing arthritis or cancer.
This strongly supports the notion that suppressing CD248
might be therapeutically beneficial. In studies to be presented
in March at an international conference in Germany, Dr.
Conway’s group will report the discovery that the pleiotropic
cytokine, transforming growth factor (TGF)-beta, dramatically
downregulates expression of CD248 in several cells. His
team has delineated some of the signaling pathways by
which TGF functions. Hopefully, these findings will lead to
the development of unique treatment strategies to reduce
inflammation and cancer.
Dr. Conway continues to hold grants from the Canadian
Institutes for Health Research (CHIR), the Canada Foundations
for Innovation (CFI), and the Natural Sciences and Engineering
Research Council of Canada (NSERC). He is also the recipient
of a CSL-Behring Research Chair and garners additional
support from several industrial partners.
97
Canada Research Chair in Inner City Medicine
Dr. Evan Wood, Professor
My research program has had a number of accomplishments
and achievements. Consistent
with the research program’s original objectives, substantial
progress has been made with
respect to:
1.
Investigating the determinants of health related harms
amongst street-involved
youth resulting in a series of high impact publications that
have now been published including three studies that
generated substantial media interest and interest among
policy makers.
2.
I have also been very active studying the treatment of
HIV among HIV-infected drug
users and have had several high impact publications in this
area as well. These findings have
been presented at a number of important scientific
conferences.
3.
I have also been active designing innovative approaches
for addiction treatment and
have submitted 2 new randomized clinical trial proposals to
CIHR. I have also been
actively involved in protocol development for a clinical trial to
be funded through the US National Institutes on Drug Abuse.
4.
Finally, I have been actively working to fulfill an
important void by training the
next generation of scientists in addiction research. This
includes raising $3,000,000 from the private sector to
establish the program.
In particular, 3 million dollars has been raised from Goldcorp
Inc. for the creation of Canada’s first interdisciplinary addiction
treatment program. Specifically, the St. Paul’s Hospital
Goldcorp Fellowship in Addiction Medicine will train a new
generation of addiction medicine physicians in partnership
with the University of British Columbia.
Research accomplishments include a study from the
Downtown Eastside looking at patterns of drug use cessation.
In addition, a range of studies have examined risk factors
for initiation of injection drug use among street-involved
youth. As indicated by the enclosed publications, there has
also been a range of studies looking at HIV treatment among
intravenous drug users.
ENDOWED CHAIRS
AstraZeneca Chair in Occupational and
Environmental Lung Disease
The Eric W. Hamber Chair in Medicine
Dr. Chris Carlsten, Assistant Professor
Dr. Graydon Meneilly, Professor
Dr. Chris Carlsten’s clinical and research interests, supported
by the Astra-Zeneca Chair in Occupational and Environmental
Lung Disease, center on occupational airways disease
including the effects of diesel exhaust and other particulate
matter on asthma induction and exacerbation. In 2012, he
continued to develop the Chan-Yeung Centre for Occupational
and Envi¬ronmental Lung Disease (http://ccoerd.spph.
ubc.ca/), home of the Air Pollution Exposure Laboratory
(APEL). Work at APEL, which investigates the effects of
combustion-derived particulate matter on the respiratory and
immunological health endpoints in humans, accelerated in
2012, producing 10 abstracts with 5 manuscripts currently in
review.
The Eric W. Hamber Chair in Medicine is one of the most
significant endowments of its kind in Canadian health
education history. Established in 1966 by Mrs. Eric W. Hamber
as a memorial to her husband, the Hon. Eric W. Hamber, former
lieutenant-governor of BC and UBC chancellor, this Chair is
the first perpetually endowed and fully supported chair or
professorship at UBC. It is a fitting memorial to the late Mr.
Hamber, who gave the strongest support as Chancellor of the
University to founding of the UBC Faculty of Medicine.
The purpose of the Chair is to support the Department Head.
Fully supported endowments of this kind are very important
in attracting outstanding medical teachers and researchers
by providing financial resources beyond those ordinarily
available to the medical school. Outstanding faculty members
become magnets for others. This is particularly important as
the competition for top teachers and researchers is growing
stronger across Canada and around the world.
I was appointed Eric W. Hamber Chair, Department of Medicine
on July 1, 2002, and was reappointed on July 1, 2007. I believe
that my strength in leadership in an ever changing environment
and my ability to be innovative, provide strategic direction and
encourage and build collaborative relationships contributes to
my success.
I have held peer-review funding from national and provincial
research agencies and have an international reputation for
studies of diabetes and carbohydrate metabolism in the elderly.
I have published over 100 peer-reviewed papers, spoken and
written widely in my areas of expertise, and have supervised
many postgraduate trainees. I have been active in hospital
service leadership in a variety of settings and am currently
Physician-in-Chief, VGH. I bring broad perspectives of personal
Of particular note, Dr. Carlsten’s team has completed an
ambitious clinical research study of the ability of diesel
exhaust to augment the immunological effects associated with
inhaled allergen exposure. Other recent results include the
novel finding of an increased miR-144 expression in peripheral
blood in those acutely exposed to diesel exhaust. Given the
literature associating air pollution with oxidative stress, along
with evidence that dysregulation of miR-144 expression
reflects perturbation in oxidative stress pathways, this is a
potentially very important finding.
Finally, Dr. Carlsten and his team have continued work on
the epidemiologic effort known as TAG (Traffic, Air pollution,
and Genes; in collaboration with Dr. Michael Brauer of the
School of Population and Public Health). TAG combines data
on over 20,000 children from 7 international birth cohorts to
evaluate the interaction between traffic-related air pollution
and genetics leading to airways disease in children. Two
98
mansucripts have been revised upon request of high-impact
journals; these show significantly increased risk of allergic
rhinitis and asthma in those children with polymorphisms in
GSTP1 (a gene that impairs metabolisms of inhaled oxidants).
achievement in clinical investigation, an intense commitment
to resident and student education, and innovative concepts
of health service delivery across communities throughout the
province.
UBC and St. Paul’s Hospital Foundation Chair in
AIDS Research
Dr. Julio S. G. Montaner, Professor
Since 1997, the endowed UBC and St. Paul’s Hospital
Foundation Chair in AIDS Research has allowed Dr. Montaner to
carry out research which has been at the center of optimizing
morbidity and mortality outcomes in BC and around the world.
More recently, Dr. Montaner pioneered the development of
HIV Treatment as Prevention in BC. The latter has become the
cornerstone of the international effort to control HIV and AIDS
in the North and the South of the world.
In 1996, Dr. Montaner led one of two international pivotal
trials responsible for the establishment of the effectiveness of
highly active antiretroviral therapy (HAART). As a result, HAART
became the global standard of care for the treatment of HIV
infection. HAART has dramatically changed the natural history
of HIV disease, from a rapidly fatal illness, to a long-term
manageable condition. As a result, life expectancy among HIV
HIV-infected patients in BC has increased to over four decades.
Starting in the early 2000’s Dr. Montaner’s research has
increasingly focused on the role of expanding coverage with
HAART to simultaneously control progression to AIDS and death
among HIV infected individuals and to stop the spread of HIV.
This strategy is commonly referred to as “HIV Treatment as
Prevention” (TasP). Under his leadership, the research team at
the BC Centre for Excellence in HIV/AIDS (BC-CfE) has provided
compelling evidence regarding the dramatic ability of HAART to
decrease HIV transmission in all settings. Of note, BC is the only
province seeing a consistent decline in new HIV diagnoses. The
most recent analysis carried out at the BC-CfE shows that this is
due to BC’s early adoption of TasP and the ongoing expansion
of the strategy in the province.
99
Based on the success of our four-year landmark BC funded
pilot project known as Seek and Treat for Optimal Prevention of
HIV/AIDS in BC (STOP HIV/AIDS in BC), the BC Government has
committed about $20M/year to support the further provincial
expansion of the program on a long-term basis. The latter
provincial expansion will be initiated April 1st 2013, under the
leadership of Dr. Montaner and the BC-CfE team.
HIV Treatment as Prevention (TasP) has now been
enthusiastically endorsed by former US President Bill
Clinton, Stephen Lewis (Former Special AIDS UN Envoy for
Africa), Michel Sidibé (Executive Director of UNAIDS), Nora
Volkow (Director, National Institute on Drug Abuse at NIH),
and Anthony Fauci (Director, National Institute on Allergy
and Infectious Diseases at the NIH), among others. Indeed,
as of 2012, HIV Treatment as Prevention (TasP) has been
incorporated in HIV treatment guidelines in resource rich
settings (ie: IAS-USA and DHHS) and resource limited settings
(ie: WHO Guidelines). Dr. Montaner is currently formally
assisting several National programs in their efforts to adapt,
implement, and evaluate the made-in-BC HIV Treatment as
Prevention strategy (ie: China-CDC in collaboration with NIDA,
Puerto Rico in collaboration with NIDA, and Swaziland in
collaboration with the Clinton Health Access Initiative – CHAI).
In 2011, Hillary Clinton and President Obama stressed the need
to refocus global AIDS control efforts to prioritize TasP. Also,
TasP was named the “#1 Scientific Breakthrough of the Year”
in December 2011 by Science Magazine. As a result of our
pioneering work in this area, in April 2013, UBC/SPH/BC-CfE
will co-host with UNAIDS, IAS, NIDA, among others, the 3rd
International HIV TasP Workshop in Vancouver.
In addition, Dr. Montaner is currently exploring possible ways
to export the “seek and treat” approach to other therapeutic
areas. Immediate target therapeutic areas include Hepatitis
B and Hepatitis C. As of April 2013, Dr. Montaner has secured
$1.5M for one year from the BC Ministry of Health to
further develop the “STOP Viral Hepatitis in BC” strategy in
collaboration with Dr. Mel Krajden at the BC Centre for Disease
Control.
In 2012, Dr. Montaner was the recipient of the Grand
Decoration of Honour for Services to the Republic of Austria
that was presented to him by the President of Austria
recognizing individuals who have provided outstanding services
and public benefit to the country. He also was awarded
the Hope is a Vaccine Award highlighting his important
contributions to improving care in the field of HIV/AIDS on local,
national, and international levels. Dr. Montaner was conferred
a Doctor of Science (honoris causa) by the Cordoba University,
Argentina. Lastly, he was the recipient of the Queen Elizbeth II
Diamond Jubilee Medal honouring his significant contributions
and achievements in the field of HIV/AIDS.
Dr. Montaner’s research and academic activities are supported
by: the BC Ministry of Health; through an Avant-Garde Award
(No. 1DP1DA026182-01) from the National Institute of Drug
Abuse (NIDA), at the US National Institutes of Health (NIH);
Genome Canada and Genome BC; and through a KT Award
from the Canadian Institutes of Health Research (CIHR). He
has also received financial support from the International
AIDS Society, United Nations AIDS Program, World Health
Organization, National Institutes of Health Research-Office
of AIDS Research, National Institute of Allergy & Infectious
Diseases, The United States President’s Emergency Plan for
AIDS Relief (PEPfAR), Bill & Melinda Gates Foundation, French
National Agency for Research on AIDS & Viral Hepatitis (ANRS),
the Public Health Agency of Canada, the University of British
Columbia, Simon Fraser University, Providence Health Care and
Vancouver Coastal Health Authority. He has received grants
from Abbott, Biolytical, Boehringer-Ingelheim, Bristol-Myers
Squibb, Gilead Sciences, Janssen, Merck and ViiV Healthcare.
Mary Pack Chair in Arthritis Research
Dr. Diane Lacaille
Dr. Diane Lacaille was appointed the Mary Pack Chair in
Arthritis Research from The Arthritis Society in July 2011. She
is a senior scientist at the Arthritis research Centre of Canada.
Her research program focuses on two areas:
1) Employment and arthritis: In previous research, she
developed and pilot tested a program to help people with
inflammatory arthritis deal with employment issues and
remain employed. In 2010 and 2011, with funds from a CIHR
Knowledge Translation and Exchange grant, she converted
the program to an online eLearning program, in response to
feedback from participants, and in order to improve future
dissemination of the program. In 2011, she obtained a five
year grant from CIHR to conduct a randomized controlled trial
to evaluate the effectiveness of the program at improving at
work-productivity and preventing work disability in people
with inflammatory arthritis. This research fills an important
unmet need in arthritis health services research and has the
potential to reduce the tremendous economic and social
burden of RA.
100
She also continues to collaborate with other Canadian and
international researchers on methodological research for the
measurement of employment outcomes, and is part of the
OMERACT initiative to determine a core set of employment
measures for RCTs in rheumatic diseases. The group is
evaluating instruments that capture limitations in people’s
at-work productivity, a concept labelled “presenteeism”. They
have also developed and are evaluating an instrument to
measure the full spectrum of social participation in valued life
activities. In July 2011, along with international collaborators,
the team obtained a grant from EULAR for a multicentre study
across Europe and North America to evaluate global measures
of presenteeism.
2) Quality of care and pharmacoepidemiology research in
rheumatoid arthritis: Dr Lacaille has assembled a populationbased cohort of rheumatoid arthritis (RA) for the province
of BC, using administrative data from the Ministry of Health.
Her research has identified important gaps in RA care. She
has shown that the majority of RA patients do not receive
the care recommended for their disease. More than half
are not using DMARDs, considered essential and few are
followed by rheumatologists. These results point to the need
for educating family physicians and patients about the shift
in RA treatment paradigms, and for increased rheumatologist
access and manpower. With funds from a Canadian Arthritis
Network grant she is currently evaluating the effectiveness
of an intervention which includes academic detailing to
family physicians, at optimizing the care of RA and improving
compliance with current RA guidelines. This research is
important to people with RA and their health care providers
and has potential to improve the quality of care and outcome
of RA.
Dr. Lacaille’s research program has also received CIHR funding
to evaluate the impact of treatment on co-morbidities of RA.
In 2011, two PhD students under her supervision published
their thesis work evaluating the impact of medications on
cardiovascular diseases in RA. One demonstrated that the
use of glucocorticoids is associated with an increased risk
of MI, but not of cerebrovascular events. Specifically, the
risk of acute MI was increased by 63% in current users of
glucocorticoids; by 12% per 5 mg increase in the current
daily dose; and by 18% per year of past cumulative use.
The second evaluated the impact of non-compliance with
statins on cardiovascular events and mortality in RA. Statin
discontinuation was associated with a 67% increase in risk
of AMI, a 60% increase in risk of cardiovascular mortality,
and an 80% increase in risk of all-cause mortality. Dr.
Lacaille is currently evaluating the use of bisphosphonates
for prevention of glucocorticoid-induced osteoporosis in
RA, and the impact of DMARD and biologic medications on
cardiovascular disease and mortality.
In 2011, Dr. Lacaille co-led the creation of a network of
Canadian researchers using administrative data for rheumatic
diseases research and surveillance and co-led a consensus
meeting in Montreal, in February 2011, to develop consensus
statements for best practices in the use of administrative data
for research and disease surveillance of rheumatic diseases.
PROFESSORSHIPS
meeting abstracts were presented and published by a number
of members of the group.
In 2012 Dr. Webb was chair and lead author of the Canadian
Cardiovascular Society Position Statement on Transcatheter
Aortic Valve Implantation published in the Canadian Journal of
Cardiology and coauthor of the Society of Thoracic Surgeons
Guidelines for Management and Quality Measures for the Aortic
Valve and Ascending Aorta which is currently in press. Currently
Dr. Webb is Director of the BC Transcatheter Valve Program for
Cardiac Services BC. Dr. Webb is director of the transcatheter
valve program at UBC for both St. Paul’s and Vancouver General
Hospitals and director of cardiac catheterization laboratories as
well as the interventional cardiology research and fellowship
programs at St Paul’s Hospital.
McLeod Family Professorship in Valvular Hear
Disease
Dr. John G. Webb, Professor
Over the past year the St. Paul’s group has continued its
work in innovative procedures for structural heart disease.
Vancouver has the world’s broadest experience with
transcatheter heart valve implantation. First in human
procedures have included transarterial and transapical
aortic valve implantation, balloon expandable pulmonary
valve implantation, device closure for transapical valve
implantation, and transcatheter valve implantation in failing
surgical valves in all 4 heart valve locations. In 2012 a
number of new transcatheter valves and delivery systems
were successfully utilized for the first time ever in Vancouver.
Multiple new adjunctive devices were also utilized for the
first time anywhere. Vancouver is recognized world wide
as a global leader in terms of new transcatheter valve
procedures, techniques, and technology.
Multiple individuals have found opportunities to participate
in this success. Jonathon Liepsic has developed a reputation
as a global thought leader in transcatheter valve imaging
and Sandra Lauck for multidisciplinary heart team program
development, Anson Cheung and Jian Ye as innovators in
surgical approaches to transcatheter valve procedures, David
Wood for reducing the invasiveness of these procedures,
and Robert Boone for implementing our percutaneous mitral
program.
During 2012 our group published in excess of 40 book
chapters and peer review journal articles, including papers
in high impact journals such as the New England Journal,
Circulation, and the European Heart Journal. In one issue
alone of the prestigious Journal of the American College of
Cardiology a total of 9 manuscripts had Vancouver authors.
The first general textbook on interventional management of
structural heart disease was published; Carroll and Webb’s
Structural Heart Interventions. A very large number of
101
During 2012 St. Paul’s continued its role of teaching new
transcatheter valve interventions. Invited presentations by the
group took place in numerous countries in Europe, the Middle
East, Asia, and Australasia, as well as across Canada and the
United States. Hundreds of physicians from these countries
participated in our regular 3 day practical courses. We have
continued our 2 year post-graduate fellowship in interventional
cardiology with clinical/research fellows during 2012 from
Switzerland, Australia, and Italy. In 2012 Dr. Webb was involved
in directing large international structural heart meetings in
Seattle, San Francisco, and London and was asked to deliver the
Founder’s Lecture at the Society of Cardiac Angiography and
Interventions. This June the largest international transcatheter
valve meeting will move to Vancouver, with ~1,000 attendees
anticipated.
Our recently opened state of the art Virtual Heart Lab media
facilities allow recording of every component of new valve
implantation procedures directly from our hybrid imaging/
operating room. Fluoroscopic, ultrasound, hemodynamic
monitoring along with live video camera images and audio of
first in man procedures can be recorded for review and teaching.
On a regular basis heart valve implants performed in Vancouver
are broadcast live with two way audio to major meetings in
other centers with thousands of physicians watching as well
as to local over flow audiences in lecture halls within St. Paul’s
Hospital.
Pacific Parkinson’s Research Institute
Professorship in Parkinson’s Research Endowment
Dr. Silke Appel-Cresswell, Assistant Professor
A generous gift from Pacific Parkinson’s Research Institute
has endowed the Pacific Parkinson’s Research Institute
Professorship in Parkinson’s Research, which has been held
since 2010 by Dr. Silke Appel-Cresswell, Assistant Professor
in the Division of Neurology.
Dr. Appel-Cresswell’s work centers on research, clinical work
and education in Parkinson’s Disease (PD). By establishing
a clinical database for BC’s only movement disorder clinic,
valuable prospective, comprehensive clinical information on
the many facets of PD is collected and can be correlated with
genetic and imaging data. Furthermore, data can be utilized
for improvements in patient care, outcome monitoring,
education and funding applications.
In close collaboration with the genetics team around
Dr. Matt Farrer, Dr. Appel-Cresswell was instrumental in
discovering a novel mutation in alpha-synuclein causing PD
and a novel mutation in DNAJC13 associated with familial
PD.
Dr. Appel-Cresswell is co-Investigator on two newly awarded
competitive grants, one of them a five-year CIHR operating
grant (PI: Dr. Matt Farrer), the other a CIHR grant to Dr.
Vesna Sossi.
Furthermore, along with Dr. Martin McKeown, she organizes
the annual “PD summit”, an educational seminar for
neurologists.
In collaboration with the Educational Technology Unit at the
Faculty of Medicine, she has developed a virtual patient case
study for medical students on movement disorders including
producing videos.
She continues to teach medical students, and residents in
the clinical setting and ensures knowledge dissemination
by giving several talks to people living with PD and their
families.
102
Glaxosmithkline Professorship in Chronic
Obstructive Pulmonary Disorder
Dr. Stephan Van Eeden, Professor
Over the past year our laboratory, with the support of the
CIHR/GSK Professorship in COPD, has made significant
contributions to the understanding of the pathogenesis of
COPD. The overarching goal of this Professorship is to address
the role of the local and the systemic inflammatory response
induced by particulate matter air pollution; specifically, how
that relates to COPD and downstream cardiovascular disease.
The research is multidisciplinary and integrated research
efforts include work at molecular, cellular, organ, intact animal
and human levels. Several papers were published addressing
this issue, in particular a landmark paper in “Chest 2012”,
quantifying the amount of particulate matter retained in the
lung in subjects with COPD. It was shown that that the more
severe the disease, the more particulate matter are retained;
suggesting a link between the ability of lungs to clear inhaled
particles and the development and progression of COPD. To
further address this issue on a more mechanistic level, studies
done in an animal model showed that this retention PM in the
lung can be altered (improved) therapeutically with commonly
used medications such as “statins”.
In these studies we showed that statins alter the function
of airspace macrophages to enhance their ability to process
and remove inhaled particles from lung tissues. Statins are
traditionally used to treat high blood lipids, but these agents
are known to have pleiotropic or anti-inflammatory properties.
These interesting and novel observations have significant
implications for the contribution of air pollution and cigarette
smoke to the development of a variety of lung diseases such
as Asthma and COPD. Currently, ongoing studies explore the
potential mechanisms of how statins impact particle clearance
in the lung, with the goal of identifying novel pathways that
can be therapeutically targeted.
In addition, several ongoing studies address the importance
of the local inflammatory response in the lung and its
contribution to the systemic inflammatory response and
downstream vascular dysfunction, suggesting that lung disease
(such as COPD and pneumonia) significantly contribute to
the development and progression of cardiovascular disease.
The work on molecular mechanisms that link chronic lung
diseases (such as COPD) and cardiovascular disease is done
in collaboration with several prominent investigators in this
field including Drs. Don Sin, James Hogg and Peter Pare.
sequence analysis tool. Journal of Clinical Microbiology. 2012
June;50(6):1936-42.
•
McGovern R, Thielen A, Portsmouth S, Mo T, Dong
W, Woods C, Zhong X, Brumme C, Chapman D, Lewis M,
James I, Heera J, Valdez H, Harrigan PR. Population-based
sequencing of the V3-loop can predict the virological response
to Maraviroc in treatment-naïve patients of the MERIT trial.
Journal of Acquired Immune Deficiency Syndromes. 2012 July
11.
•
Poon A, Swenson L, Bunnik E, Edo-Matas D,
Schuitemaker H, van ‘t Wout A, Harrigan PR. Reconstructing
the dynamics of HIV evolution within hosts from serial deep
sequence data. PLoS Computional Biology. 2012 November; 8
(11): e1002753.
Glen-Hillson Professor in Clinical HIV Virology
Dr. Richard Harrigan, Professor
Dr. Harrigan is the Director of Research Laboratories at
the BC Centre for Excellence in HIV/AIDS. For more than
a decade, Dr. Harrigan has been a local, national, and
international leader in the development of cutting-edge
translational research with important implications for the
clinical management of HIV. He has contributed extensively
to our understanding of HIV drug efficacy and resistance, as
well as the human and viral parameters that influence HIV
disease progression. His lab has developed and distributed
software for improved automated analysis of HIV drug
resistance (“ReCall”), which is now being used worldwide.
Dr. Harrigan’s research in these areas has played a key
role in enabling the significant improvements in quality
and duration of life afforded patients by Highly Active
Antiretroviral Therapy (HAART). In recognition of his work
in this area, in March of 2012, Dr. Harrigan was the recipient
of the UBC Faculty of Medicine Distinguished Achievement
Award (Basic Science).
His work primarily focuses on HIV drug efficacy, drug
resistance, and the human and viral parameters that
influence HIV disease progression. At the BC Centre for
Excellence in HIV/AIDS, his work has involved investigations
using three major cohort studies (VIDUS, VLAS, and
Vanguard), as well as the more than four thousand patients
in the BC Drug Treatment Program. Research from these
cohorts has produced over 230 peer-reviewed papers over
the years. Papers with significant impact from 2012 are:
•
Woods C, Brumme C, Liu T, Chui C, Chu A, Wynhoven
B, Hall T, Trevino C, Shafer R, Harrigan PR. Automating HIV
drug resistance genotyping with RECall, a freely accessible
103
HIV infection is characterized by a continuous, dynamic
evolution of the viral population as it adapts to its environment
as a result of host genetic factors and antiretroviral drug
pressure. These parameters are insufficiently understood,
and their investigation in a “real world” clinical setting can
complement randomized clinical trials and prove particularly
useful for determining longer-term outcomes.
As well as the Glen-Hillson Professor in Clinical HIV Virology,
Dr. Harrigan also holds the CIHR-GSK Research Chair in HIV/
AIDS at the University of British Columbia, and is a Professor in
the Division of AIDS (Faculty of Medicine) at the University of
British Columbia.
diagnostic procedures, less aggressive treatment and worse
outcomes at one year after discharge from the hospital.
The results of this study will help determine whether sexspecific cut-points for cardiac troponin are required to more
appropriately risk-stratify women with chest pain.
UBC Heart and Stroke Foundation Professorship in
Women’s Cardiovascular Health
Dr. Karin H. Humphries, Associate Professor
It has been an exciting year for the women’s cardiovascular
health program. Established as the first research program in
BC to focus on sex differences in cardiovascular disease, the
goal of this professorship is develop innovative strategies
to improve care, education and quality of life for women
across the province. In the past year, we successfully secured
two operating grants from the Canadian Institutes of Health
Research (CIHR), recruited a promising young researcher
to the team, and published a key paper in the high impact
Journal of the American College of Cardiology.
The newly secured funding from CIHR has enhanced our
ability to understand sex differences in the diagnosis and
treatment of acute myocardial infarction. The first funded
project will examine sex differences in lifestyle changes
made by young adults who have survived their first heart
attack. While patient education and support programs are
readily available, it has been found that men and women
are still unsuccessful in adopting new lifestyle behaviours.
The study will use an institutional ethnographic approach to
better understand the barriers that exist, and will consider
the perspectives of the patients, formal and informal
caregivers, as well as health care leaders. The results of
this research will inform changes to programs and health
professional practices so that men and women will be
supported in ways that are meaningful to them in their
efforts to change lifestyle habits and reduce the risk of
rehospitalization.
Our second project will examine whether cardiac troponin
levels are lower in women compared to men when
presenting with chest pain suggestive of ischemic heart
disease. Evolving research has shown that acute coronary
syndrome (includes myocardial infarction and unstable
angina) manifests differently in women than men. However,
there is only one troponin cut-point currently used for
diagnosis. We will determine whether lower levels of
troponin in women are associated with less frequent use of
104
This past fall, we recruited a post-doctoral fellow, Dr.
Chakrapani Balijepalli, who will use data linkage to
determine whether the effectiveness of statins varies by sex
and/or ethnicity. He will also examine whether South Asian
subjects, on statins, are more likely than their Caucasian
counterparts to develop diabetes mellitus. Dr Balijepalli
completed his PhD at the University of Duisburg-Essen in
Germany and joins the team with over 5 years of experience
in epidemiology and patient outcomes research and
evaluation.
Recently we completed our 3-year study of young adults
who survived an acute myocardial infarction. This study
examined the psychosocial aspects of recovery following
discharge from the hospital. We determined that women
were more likely to experience depression compared to
men, as well as report lower quality of life. The study
also discovered that many patients were unsure about
what lifestyle changes they should make after their heart
attack, and what role cardiac rehabilitation could play in
their recovery. They were also uncertain about the use
of medications prescribed at discharge and when they
could return to work. These findings have inspired the
development of a strategy to address the ‘care gap’ between
the acute care setting and the patients’ return to the
community. In the fall of 2013, we will submit a funding
application to examine the impact of a nurse navigator, an
individual who facilitates access to health resources, on
patient satisfaction and ability to adopt lifestyle changes that
will improve both short and long term outcomes.
Finally, our group published a key paper on sex differences in
outcomes following transcatheter aortic valve implantation
(TAVI). This research was published in the Journal of the
American College of Cardiology and was featured at the
2012 European Society of Cardiology conference in Munich,
Germany. Using data from BC and Laval, Quebec, we
demonstrated a significant mortality advantage in women
compared to men, following TAVI that extend out to two
years.
Moving forward, we will focus our efforts on evaluating time
trends in hospital admission for acute myocardial infarction,
as well as time trends in 30-day mortality following
admission. In particular, we will focus our attention on
younger women, 55 years of age or younger, in whom higher
admission rates and high mortality rates have been reported.
U B C D E PA R T M E N T O F M E D I C I N E
M E N T O R I N G P RO G R A M
Vision: Every new tenure track and grant tenure track department member will have a welcoming and
supportive relationship with an established academic mentor throughout the initial years of their appointment
and until their achievement of tenure and promotion to Associate Professor. The mentor will establish a secure
and confidential environment of trust within which to share their wisdom and experiences, and to coach, challenge and sponsor their mentee.
The Department of Medicine would like to acknowledge the following faculty members for their invaluable
contributions to this important program.
Dr. Aslim Anis
School of Population & Public Health
Dr. Sam Aparicio
Pathology and Laboratory Medicine
Dr. Najib Ayas
Medicine (Critical Care Medicine)
Dr. Marcel Bally
Pathology and Laboratory Medicine
Dr. Lynn Beattie
Medicine (Geriatric Medicine)
Dr. Oscar Benavente
Medicine (Neurology)
Dr. Michael Brauer
School of Environmental Health
Dr. Stirling Bryan
Medicine (Respiratory Medicine)
Dr. John CairnsMedicine (Cardiology)
Dr. Adele DiamondPsychiatry
Dr. Sharlene Gill
Medicine (Medical Oncology)
Dr. Karin Humphries
Medicine (Cardiology)
Dr. Nadia Khan
Medicine (General Internal Medicine)
Dr. Jacek Kopec
Dr. David Li
Radiology
Dr. Paul Man
Dr. Heather McKay
Centre for Hip Health & Mobility
Dr. Robert McMaster
Medical Genetics
Dr. Deborah Money
Obstetrics & Gynecology
Dr. Anita Palepu
Medicine (General Internal Medicine)
Dr. Peter Pare
Dr. David Patrick
Dr. Lynn Raymond
Psychiatry
Dr. Glen Regehr
Centre for Health Education Scholarship
Dr. Neil Reiner
Medicine (Infectious Diseases)
Dr. Frank Ryan
Dr. Jean Shoveller
Dr. Don Sin
Dr. Terence SnutchPsychiatry
Dr. John Spinelli
Dr. Roger Wong
Medicine (Geriatric Medicine)
105
AWA R D S & H O N O U R S
Ballem, Penny (Hematology)
Wallace Wilson Leadership Award, Faculty of Medicine Alumni
Association
Beattie, Lynn (Geriatric Medicine)
The Queen Elizabeth II Diamond Jubilee Medal
The MILES Award for Mentorship, Innovation, and Leadership
in Education Scholarship, Asia-Pacific Medical Education
Conference
Beaulieu, Monica (Nephrology)
Medical Lead, BC Kidney Care Advisory Group
John Ruedy Award for Innovation in Medical Education,
Association for Faculties of Medicine in Canada
Bowie, William (Infectious Diseases)
Excellence in BC Health Care Award, Health Employers
Association of BC
Outstanding Achievement Award in the Evaluation of Clinical
Competence, Medical Council of Canada
Cairns, John (Cardiology)
Margolese National Heart Disorders Prize, UBC
President, Canadian Academy of Health Sciences
Cashman, Neil (Neurology)
Genome BC Award for Scientific Excellence
Chow, Anthony (Infectious Diseases)
Canada Lifetime Achievement Award, Association of Medical
Microbiology and Infectious Disease (AMMI) Canada
Cook, Wendy (Geriatric Medicine)
Donald M. Whitelaw Award for Outstanding Grand Rounds
Presentation, UBC Department of Medicine
Dodek, Peter (Critical Care Medicine)
Martin M. Hoffman Award for Excellence in Research, UBC
Department of Medicine Faculty Research Award, Providence
Health Care
Eisen, Andrew (Neurology)
British Columbia Community Achievement Award for
contribution to ALS
Queen Elizabeth II Diamond Jubilee Medal
Esdaile, John (Rheumatology)
Masters of the American College of Rheumatology
2012 Jonas Salk Award, March of Dimes Canada
Ezzat, Hatoon (Hematology)
Awarded MSc in Hemoglobinopathy (University College
London, UK and the International Thalassaemia Federation)
106
Eva, Kevin (General Internal Medicine)
Distinguished Achievement Awards for Excellence in Education,
UBC Faculty of Medicine
Finlayson, Heather (Physical Medicine & Rehab)
Duncan Murray Award for Excellence in Teaching
FitzGerald, J. Mark (Respiratory Medicine)
International Workshop Award for Health Literacy, Peter Wall
Institute
Visiting professor, China-Japan Friendship Hospital, Beijing
Martin M. Hoffman Award for Excellence in Research, UBC
Gill, Jagbir (Nephrology)
CIHR grant recipient RE: Ethnic Differences in Organ Donation Gill, John (Nephrology)
President, Canadian Society of Nephrology
Gin, Kenneth (Cardiology)
Council Member, Canadian Cardiovascular Society
Chair, Journal Committee, Canadian Cardiovascular Society
Harrigan, Richard (AIDS)
CIHR/GSK Research Chair Award in HIV/AIDS at the University of
British Columbia
UBC Faculty of Medicine Distinguished Achievement Award
(Basic Science)
BC-CfE Meritorious Service Recognition Award
ACCOLAIDS Science, Research & Technology Award, Positive
Living Society of BC
AWA R D S & H O N O U R S
Hsiung, Robin (Neurology)
CIHR Institute of Genetics Clinical Investigator Award (renewed)
Huckell, Victor (Cardiology)
Illes, Judy (Neurology)
Elected to the Royal Society of Canada
Fellow of the American Association for the Advancement of
Science (AAAS)
Jacova, Claudia (Neurology)
Certificate of Excellence in Research Mentorship
Kerr, Thomas (AIDS)
Scholar Award, Michael Smith Foundation for Health Research
Madden, Kenneth (Geriatric Medicine)
Award for Scholarship, Prix Silver Quill Award for Knowledge
Translation, Canadian Physiotherapy Association
Meneilly, Graydon (Geriatric Medicine)
Honorary Medical Alumni Award, Faculty of Medicine Alumni
Association
Mills, Patricia (Physical Medicine & Rehab)
Mentored Clinician Scientist Award, Vancouver Coastal Health
Research Institute
Montaner, Julio (AIDS)
The Grand Decoration of Honour for Services to the Republic of
Austria, Government of Austria
Kenyon, Michael (General Internal Medicine)
Clinical Faculty Award for Excellence in Community Practice
Teaching, UBC Faculty of Medicine
Krassioukov, Andrei (Physical Medicine & Rehab)
Hope is a Vaccine Award, Global Alliance to Immunize against
AIDS
Fellowship in the Canadian Academy of Health Sciences (CAHS)
Honorary Degree, Doctor of Science-honoris causa, Cordoba
University, Argentina
Krieger, Charles (Neurology)
107
Mancini, John (Cardiology)
Distinguished Service in CME/CPD Award, UBC Faculty of
Medicine
Honorary Life Member of the ALS Society of British Columbia
Moore, David (AIDS)
Career Investigator Award, Michael Smith Foundation for
Health Research
Lacaille, Diane (Rheumatology)
New Investigator Award, Canadian Institutes for Health
Research
Lee, Agnes (Hematology)
Served as co-Chair of the American Society of Hematology
Education Program
McCormick, Iain (General Internal Medicine)
Fay R. Dirks Award for Excellence in Teaching, UBC Department
of Medicine
Levy, Robert (Respiratory Medicine)
Institute of Public Administration of Canada/Deloitte
Public Health Leadership Award (Bronze)
Nevill, Tom (Hematology)
Completed a 2-year term as President of the Canadian
Hematology Society
Li, Charles (Hematology)
Became Chair of the Department of Medicine Clinical Faculty
Affairs Committee
Peets, Adam (Critical Care Medicine)
Young Educators Award, Association of Faculties of Medicine of
Canada
Lima, Viviane (AIDS)
Career Investigator Award, Michael Smith Foundation for
Health Research
Poon, Art (AIDS)
Career Investigator Scholar Award, Michael Smith Foundation
for Health Research/St. Paul’s Hospital Foundation-Providence
Health Care Research Institute
A WA R D S & H O N O U R S
Ryerson, Chris (Respiratory Medicine)
Junior Investigator Award (travel stipend), International
Colloquium on Lung and Airways Fibrosis
Shannon, Kate (AIDS)
MSFHR Career Investigator/Scholar Award, Michael Smith
Foundation for Health Research
AccolAIDS Nomination - Science/Health Promotion, Positive
Living Society of BC
Stiver, Grant (Infectious Diseases)
Vancouver Acute Services Physician Academic Award
Vancouver Acute - Vancouver Coastal Health
Tier 1 Canada Research Chair in Medicine
Yoshida, Eric (Gastroenterology)
Elected to Fellowship in the Canadian Academy of Health
Sciences (CAHS)
Stoessl, Jon (Neurology)
Zalunardo, Nadia (Nephrology)
Donald M. Whitelaw Award for Outstanding Grand Rounds
Presentation, UBC Department of Medicine
Tan-Hogg, Wan (Respiratory Medicine)
Dr. Norman Jones Award, CRJ’s publisher Pulsus Group
STAFF AWARDS
Tang, Anthony (Medicine)
Top Achievements in Health Research Award, Canadian
Institutes of Health Research & Canadian Medical Association
Journal
Toma, Mustafa (Cardiology)
Graeme Copland and Fay R. Dirks Award for Excellence in
Teaching, UBC Department of Medicine and St. Paul’s Hospital
Townson, Andrea (Physical Medicine & Rehab)
Theo van Rijn Award for Contribution to the Residency Program
Travlos, Andrew (Physical Medicine & Rehab)
Clinical Faculty Award for Excellence in Clinical Teaching, UBC
Faculty of Medicine
Wong, Graham (Cardiology)
Dr. Shelley Naiman Award for Clinical Teacher of the Year,
UBC Department of Medicine Residency Training Program
Dr. Bobby Miller Award for Excellence in Teaching, Vancouver
General Hospital Medical, Dental and Allied Staff
Wong, Roger (Geriatric Medicine)
Master Teacher Award, UBC Department of Medicine
108
Wood, Evan (AIDS)
Named one of Business in Vancouver’s Forty under 40
Business in Vancouver
Bishop, Kathy (Infectious Diseases)
Department of Medicine Award of Excellence for M&P
Fitzsimmons, Sabina (DoM Administration)
Department of Medicine Award of Excellence for CUPE 2950
Staff
Hermkens, Karen (Hematology)
Department of Medicine Award for Career Excellence
Li, Yuping (Neurology)
Department of Medicine Award of Excellence for Non-union
Technical Staff
Martens, Paola (DoM Undergraduate Administration)
Department of Medicine Early Career Excellence Award
Ng, Yvonne (Neurology)
Department of Medicine Award of Excellence for M&P
ADMINISTRATION
Departmental Review
The Department of Medicine external review was held on
February 13th and 14th, 2012. The department received a
very positive report from the reviewers, and is now working on
addressing and implementing the recommendations.
Division Reviews
Two divisions were reviewed: Physical Medicine and
Rehabilitation (January) and Rheumatology (November).
Reviewers’ reports have now been received for both
divisions and the division heads are working to address the
recommendations.
Education Task Force
In early 2012 the departmental executive approved the
recommendations brought forward by the Education Task Force.
In October 2012, Dr. Adam Peets was appointed Associate Head,
Education, and Kathy Standeven took on the role of Senior
Manager, Education.
Finance
2012 marks year five of the University’s re-payment process
for underwater endowments. Changes to financial business
practices in the areas of P-Card reconciliation and audits were
also introduced.
Divisions raised over $12,900 for various initiatives with the
help of Stephanie Huehn, Development Coordinator, Faculty of
Medicine Dean’s Office.
Human Resources
Team Restructure
In order to provide excellent customer service to our clients
in the divisions and to meet the demands of our increased
workloads, a restructuring of the HR team was undertaken. The
Department now has three Human Resources Assistants that
support the divisions. In addition, the CV Secretary role was
moved from the administration team to the human resources
team to support efficiencies.
Health and Wellness Program
The Health and Wellness Program held three very well received
seminars in 2012. The first seminar was held in April 2012
and the presenters were from UBC BodyWorks. This seminar
outlined the key components of a healthy lifestyle and helpful
tips to make them a reality. The second seminar was held
in June 2012 and the presenter was Dr. Chris Carlsten. This
seminar provided an introductory discussion around indoor
and outdoor air pollution as well as the effects it has on our
lung heath and tips for prevention. The last seminar of the
year was held in September 2012 and the presenter was Dr.
Robert Schellenberg. This last seminar provided an introductory
discussion regarding the cases and effects of indoor and outdoor
allergens.
109
Division Head 360 Feedback
The Division Head 360 Feedback Tool was implemented in 2012
with the purpose of providing division heads with confidential
feedback from supervisors, stakeholders, peers, and direct
reports. This is not a performance management tool; rather
it is a way of receiving feedback and further developing
leadership skills. The 360 feedback process occurs at the two
to three year mark of each division head’s term. The first group
of division heads participated in September 2012.
360 Feedback for M&P Staff in the Administration Office
The managers in the Department of Medicine’s Administration
Office who have passed their probationary period meet with
the Department of Medicine’s Director of Administration and
Department Head once a year to receive feedback about their
performance over the past year and to set goals and plans
for the upcoming year. In 2012, the Administration Office
implemented a 360 feedback element into the managers’
performance reviews. Clients and colleagues of each manager
were asked to provide feedback in the areas of leadership,
interpersonal skills, accountability, communication, and
customer service. This was a useful element which provided
managers with an understanding of how their work is perceived
by the people they work with.
Providing excellence in patient care,
teaching and research
University of British Columbia
10th Floor - 2775 Laurel Street
Vancouver, BC
Canada V5Z 1M9
T: 604 875 4107
F: 604 875 4886
www.medicine.ubc.ca

2012 Annual Report - Department of Medicine

Transcription

Similar documents

Did you know that Kidsbooks in Vancouver was the first bookstore in

Pocket Guide UBC - Freie Universität Berlin

The big picture: Enrolment targets

TOWNSHOES PARK ROYAL FIT OUT

details - UVic Libraries Blogs

Three Things - UBC Grad School

oo-k thefts- it new peak last session

activity guide - Re-Imagine Aging