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 I
-t,
^g Cutting edge,
without the cu
17  Voyages of (cultural)
discovery
Philanthropists bet
on the Faculty of
Medicine
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VOL 9   |   NO 1   SPRING 2013   THE MAGAZINE OF THE UBC FACULTY OF MEDICINE
a place of mind I      the university of British Columbia UBC
FACULTY OF MEDICINE
EDICINE
MESSAGE FROM THE VICE PROVOST HEALTH AND DEAN
FOCUS ON: RESIDENTS
B.C. expands opportunities for international medical graduates
Basic training: A residency program gets physical
The double life of pediatrics resident Kristopher Kang
Resident researchers
Learning medicine at the boundaries of the world
Investigations & breakthroughs
Cutting edge, without the cutting
Voyages of discovery, close to home
Enhancing excellence: New arrivals to the Faculty of Medicine
Philanthropists bet on the Faculty of Medicine for live-saving solutions
Olympic ambitions - both athletic and medical
Self-health: Sun Life supports online risk assessment tool
Making a mark: Achievements & awards
One B.C. leader pays tribute to another
A family focus on an obscure disorder
A new technology to explore the lower intestine
MEDICAL ALUMNI NEWS
UBC MEDICINE
VOL. 9 | NO. 1  SPRING 2013
A publication of the University
of British Columbia's Faculty
of Medicine, providing news
and information for and about
faculty members, students,
staff, alumni and friends.
Letters and suggestions are
welcome. Contact Brian Kladko
at brian.kladko@ubc.ca
Send address corrections to
patricia.gray@ubc.ca
Editor/Writer
Brian Kladko
Contributing writers
Brian Lin
Anne McCulloch
Daniel Presnell
Design
Signals Design Group Inc.
www.signals.ca
Online at
http://med.ubc.ca/news/
ubc-medicine-magazine
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»iipi"Hinimii
FSCCOI1M7 DEAN'S GREETING
ESSAGE FROM THE
VICE PROVOST HEALTH AND DEA
When my grandfather graduated from medical school in Dublin
in the 1920's, his subsequent residency was on the high seas:
he served as a ship's doctor with the Cunard Line. Very little
emphasis was put on education — this had been completed,
and he was thrown into the new role as healer without anyone to
mentor or supervise him.
When my father and father-in-law graduated from medical school
some three decades later, the concept of medical residency
had evolved — somewhat.The apprenticeship model gave
way to a more balanced mix of apprenticeship, education and
ndependent practice, unfolding over a period of five to seven
years characterized by long hours, limited pay and sometimes
great responsibility.
Bythe time I entered post-graduate training, in the 1970's, it had
evolved even further from an apprenticeship, as education and
training became a more formal part of the program, with defined
[earning objectives. Nonetheless, it still involved "one-in-two call"
and 1 2- to 1 6-hour days in the hospital.
Today, thankfully, residency has mostly forsaken the "breaking
in" approach of my grandfather's era. Governed by the Royal
College of Physicians and Surgeons of Canada and the College of
Family Practice of Canada, residencies are rigorous educational
programs based upon principles of patient safety, pedagogy and
evidence-based care. Patient safety requires limited work hours.
Work-life balance is now an acceptable principle to consider in
the design of residency programs. Protocols of care are founded
on clear evidence.
Notwithstanding the many changes over the last century, three
principles remain pre-eminent in residency training. One is the
notion that caring for a patient is a privilege, and that we should
be aware of our responsibility to earn the trust of those for whom
we provide care. Another constant is the importance of role
models — there is simply no substitute for emulating the care of
our most experienced, exemplary colleagues in the profession. The
third principle is the primacy of evidence — learning how to find it,
knowing what level of scientific rigor is needed in a given situation,
and becoming adept in applying it judiciously.
Much has changed in residency, yet those basic principles remain
the same. It is a crucial, formative period in a physician's career, but
one that doesn't get proper recognition, owing to its transitional
identity. In this issue, UBC Medicine tries to compensate for that,
by highlighting how big a role residency programs now play in our
activities, the challenges of being a resident or providing training
for them, and the contributions that residents make to the Faculty
of Medicine and to the populations we serve.
Please let me know what you think of our effort, or if you have
other stories to share. This certainly isn't meant as the final word
on post-graduate training, but simply as an opening to further
discussion — a discussion that could guide residency's continuing
evolution from the days of "sink or swim."
Gown C.E. Stuart, MD, FRCSC
Vice Provost Health, UBC
Dean, Faculty of Medicine CUS ON:
SIDENTS
,
4652 493 ^
<fr
DIFFERENT JOURNEYS,
SAME DESTINATION:
^
M*
i&^E L- R:KirtiAneja, Suzanne Walter, photo credit: martin dee
B.C. EXPANDS OPPORTUNITIES FOR
TERNATIONAL MEDICAL GRADUATES
As a practicing anesthesiologist in northern India, Kirti Aneja
thought she had it all. Not only was she fulfilling her childhood
ambition of becoming a doctor, but she was happily married
to her medical school sweetheart and was expecting their
first-born son.
But she and her husband then made a bold decision:They left
their beloved homeland to pursue a better life for their children,
and for a chance to use their medical skills in an entirely new
setting — Canada.
Dr. Aneja is an international medical graduate (IMG), one of a
group of permanent residents or Canadian citizens who were
trained outside of North America and are now seeking to
practise medicine in Canada.
To ensure a high level of care in communities around the
province, the process of integrating skilled and passionate
medical graduates from overseas is rigorous.
While the U.S. and Canada share similar curricula and
accreditation standards for medical students, systems vary
widely around the world. Many do not, for example, demand the
same level of training in a clinical setting that is required by
Canadian medical education.
So all medical graduates trained outside of North America must
complete a series of exams run bythe Medical Council of Canada.
Then, to enhance their likelihood of success when applying for
a residency position, UBC offers a clinical assessment program,
in which applicants work alongside experienced physicians in
hospitals for two months.
Those accepted into a residency position then spend another two
to seven years in training, depending on their specialization, before
they can qualify for a license to practice.
Dr. Aneja had completed three years of residency training in India.
But here in Canada, she had to start over. While preparing for
exams and looking after her young son, Dr. Aneja worked in
Walmart to make ends meet.
Tm a fighter," she says. "We came here for a better life for our
family and our son, and I don't give up easily."
Dr. Aneja passed all of her exams and the clinical assessment in
two-and-a-half years. She began her residency in the southern
Fraser Health region, including Langley Memorial Hospital and
Surrey Memorial Hospital, in July 201 2.
"I was determined to practise medicine in Canada, but it was
definitely challenging," says Dr. Aneja, whose husband is still
in the process of qualifying for residency training.
Another international medical graduate, Suzanne Walter,
took a very different route to her medical residency.
Raised in North Vancouver, she earned a BSc from UBC in 2000.
While traveling in Europe, she decided to become a doctor, and
enrolled in the University of Freiburg medical school, in Germany.
After earning her M.D. there, she returned to Vancouver in 2008.
It took her another two-and-a-half-years to complete the
required exams and assessments before beginning residency
training in 2010.
"In retrospect, I might have been a little naive about what it
would take to come back to practise in B.C.," says Dr. Walter,
who admitted that at times she felt deserving of special
consideration as a natural Canadian.
"But the longer I was in the program, the more I realized that
all the IMGs are Canadians - some have been here as long as
10 years and separated from their partners or children,"she says.
"Many of the IMGs I know aren't here for their own careers - they Two of the main training sites for international medical graduates: Royal Columbian Hospital in New Westminster, and RoyalJubilee Hospital in Victoria.
DHOTO CREDIT (ROYAL COLUMBIAN HOSPITAL): J ERALD WALLISER
Continued from p5
had a good life in their home countries as doctors.They were well-
respected and made good money. They're here because they want
a better life for their children, and as a new mother myself, I get it."
The shared ambitions of Dr. Aneja and Dr. Walter have dovetailed
with the province's need for physicians — particularly family
physicians, pediatricians, psychiatrists and internists in
mid-sized urban centres and rural and remote communities.
That alignment of ambition and demand led the B.C. government
to increase funding for the IMG program. It has partnered with
the Faculty of Medicine to add 32 more IMG training slots to
the existing 26 by 2017.
That expansion has not been simple.To meet Canadian
accreditation standards, IMG residents — like all other residents
— must be exposed to a variety of patients, and a variety of patient
llnesses, injuries and conditions.
"All residents must have experience providing care from cradle to
grave, and a variety of demographics and socio-economic status,"
says IV/lla Henry, director of UBC's Family Practice residency
program. "We're increasingly exposing them to different geographic
regions and health care settings."
Moreover, Dr. Henry says, they must be closely supervised
by preceptors — senior physicians, often with extensive
cross-cultural experience and broad clinical backgrounds,
who serve double-duty as teachers.
But teaching capacity has already been stretched to
accommodate the doubling of UBC's medical education program
over the past decade. Even with a growth in the number of
clinical teaching physicians, from 2,500 in 2004 to 5,000 in 201 2,
the number of senior physicians who can provide training in
underserved areas is limited.
"Expanding the IMG program, like expansion of UBC's medical
undergraduate program, requires extensive planning, to make
sure all of the pieces are in place," says David Snadden, the
Faculty's Executive Associate Dean, Education.
"But the dividends are enormous. B.C. is able to harness the
skills and commitment of ambitious, capable physicians, many
of whom are eager to practise in places where physicians are in
short supply."
That reciprocal relationship includes a "return-of-service,"
in which the newly-licensed physicians are assigned to practise
in an underserved community for two years. Since the last
program expansion in 2006, seven IMGs have remained to
practise in the underserved areas where they completed their
return-of-service contracts.
Since 2006,seven IMGs have remained to
practise in the underserved areas where they
completed their return-of-service contracts.
For Dr. Aneja, the prospect of practising family medicine in
an underserved community, and working with a range of health
professionals in Canada's universal health care system, fulfills
her childhood ambitions in ways she had never envisioned.
"India has a two-tier, public-private system, with the public system
catering mostly to the poor and the private system operating much
[ike a commercial industry— if you have money, you shop around
for doctors who give you what you want," she says. "The health care
system here is much more collaborative. As a family physician,
I'll get to work with people from all walks of life and ensure my
patients get the best care possible."
Despite a detour in the Walmart photo department, Dr. Aneja
says the journey has been well worth it.
For Dr. Walter, the journey is more of a homecoming—one that
enables her to give back to the province where she was raised.
"I grew up here, I knew I liked it here, this is where I wanted to be,"
she says. FOCUS ON
L-R; Rheumatology resident Corisande Baldwin in mid-workout; Clinical Professor Kam Shojania (far right), with his residents and colleagues behind him,
strengthen their quads, glutes and hamstrings, photocredit: martin dee
BASIC TRAINING: A RESIDENCY
PROGRAM GETS PHYSICAL
It has always been a bit of an embarrassment that residency, the
period when newly-minted doctors are suddenly immersed in
their new roles, also happens to be a particularly unhealthy time
for many of them.
A study of 614 residents in a variety of fields, published in the
American Journal of Obstetrics and Gynecology, found that
doctors-in-training ate fewer meals, ate more high-fat meals,
slept less and exercised less than they did before entering
residency.
It happened to Kam Shojania when he was a resident. And years
later, as Head of the Division of Rheumatology, he noticed it in his
trainees.
"I started wondering, 'Why am I more energetic than the residents
who are younger than me?'" says Dr. Shojania, a Clinical Professor.
"They look stressed and tired. And it's just not right. I'm 20 years
older than they are!"
Dr. Shojania also didn't like what he saw among his colleagues: a
lot of overweight individuals, walking slowly and tottering, due to
weak core muscles and tight hamstrings.
"It's a shame to see that, because we have to practice what we
preach," he says. "Physicians who exercise themselves are much
more likely to recommend exercise to patients."
So every Friday afternoon, Dr. Shojania and nearly all of his
rheumatology residents convene at a fitness centre near
Vancouver General Hospital, to strain, sweat and swear their way
to a healthier life.
During one session, a pair of trainers exhorted Dr. Shojania and the
residents through a metabolic workout: a series of minute-long
drills of pushing, pulling and holding.
"I find it's like taking medicine — like methotrexate," says fifth-
year resident Mitch Uh. "But methotrexate doesn't hurt."
Dr. Shojania hit upon the idea last summer, when he noticed that
his residents tended to disappear toward the end of academic
days.
"They would say, 'There's no way I can learn anything on Friday at
four o'clock.'And I thought, 'Yeah, you're right. So we're not going to
[earn anything. We're going to workout.'"
Such programs are rare in medical education, according to
a literature review by Shannon Lockhart, a third-year UBC
medical student who studied Dr. Shojania's exercise initiative
and presented a poster on it at the Canadian Rheumatology
Association's annual scientific meeting in February.
Lockhart's survey of the five participating residents found that
they all enjoyed it (appearances to the contrary), and three of the
residents said it gave them more confidence in their own ability to
prescribe or promote exercise to their patients.
"Now, when I tell residents to explain to back pain patients how
to strengthen their core, they know how to do it — they can even
demonstrate," Dr. Shojania said. "Before, that would have been an
abstract thing for them. You don't learn how to strengthen your
core in med school."
All of the residents reported that they were exercising more -
beyond the weekly, semi-obligatory sessions - and that their diet,
stress levels, sleep habits, mood and learning had improved since
beginning the regimen.
"Before this, I wasn't very good about exercising," said fourth-year
resident Ann Marie Colwill. "It helped to have this scheduled, to
make sure we did it."
The sessions have also contributed to greater camaraderie among
the residents, including post-workout drinks at a nearby pub.
"Yes, that does take away some of the health benefits," Dr. Shojania
says. "But it also promotes the idea of physician as collaborator.
Here is a way that they can encourage each other." Kristopher Kang in the corridors ofBC Children's Hospital, and outside the local chief's office in a poverty-stricken neighborhood nearAbuja, Nigeria
THE DOUBLE LIFE OF PEDIATRICS RESIDENT
KRISTOPHER KANG
Like his fellow pediatrics residents at BC Children's Hospital,
Kristopher Kang is consumed with the challenges of a medical
trainee — tendingto patients, learning treatment protocols,
conducting research, navigatingthe bureaucracy.
And then, when he gets the rare chance to take a break from
it all, he immerses himself in a completely different set
of challenges — gunfire and bombs, subsistence poverty
rudimentary governance.
Dr. Kang works as a United Nations consultant in some of the
poorest or most violent corners of the world. As far removed as
those two occupations may be, they share a common goal — caring
for children.
As a consultant, he has become an expert on two aspects of child
protection in low-income countries: expanding birth registration,
so that more children can get access to schooling and health
care, and finding alternative care for children who have lost their
parents or have been separated from their families.
Dr. Kang, 29, has become one of the U.N.'s go-to analysts on both
issues, valued for his ability to quickly find the right people to
nterview, and distill what he learns into practical reports - and
most important, advice - for government officials.
"I'm told, 'Fix this' or 'Figure this out,'" Dr. Kang explains. "They say
'You can meet with anybody you want, we'll take you wherever you
want to go, you have this many days. Let's make a plan.'Then we
negotiate on deliverables."
Dr. Kang, a native of Kamloops, discovered his knack for factfinding and analysis on behalf of children soon after graduating
from Princeton University — first as a research assistant at
Columbia University, and then working for a child advocacy group
at UNICEF's New York headquarters.
A year later, in 2007, the U.N. sent him to Nepal to develop
"how-to" documents for South Asian politicians and policymakers interested in tackling child protection issues, including
care for parentless children and supporting those affected by
HIVandAIDS.
In the midst of that assignment, he was sent to Afghanistan to
get a handle on that country's large number of institutionalized
children, and to help craft a strategy for returning those children to
relatives. He returned to Afghanistan in 2008, working directly for
the Afghan government on that same issue.
"There were guns everywhere," he says. "We always rode
in a U.N.-marked car.There were often gunshots at night.
Sometimes, there were big explosions, and we wouldn't be able
to go to work the next day."
He took a break from his consulting work as a UBC medical
student, but returned to it in 2011 as a first-year resident, when
the U.N. hired him to conduct a bottleneck analysis of the birth
registration system in Nigeria, where 70 per cent of children under
5 years old - about 18 million - are not registered.
"We ended up with a massive amount of data about what was
going on," Dr. Kang says. "We were able to map out where the
major barriers were, prioritize them, and propose interventions to
improve coverage and monitoring."
Still, most of Dr. Kang's time is focused on pediatrics, where he is
developing a focus on pediatric cardiology, due in large part to the
mentorship of Associate Professor Shubhayan Sanatani.
"His work ethic is phenomenal," Dr. Sanatani says. "He pushes
himself very hard. And at the same time, he is one of the most
humble residents in the program." RESIDENT RESEARCHERS
Doug Brown ascending a peak in the Cascades.
Medical residents play two roles —they are physicians, caring
for patients, and they are trainees, soaking up the vast amount of
knowledge necessary to become expert practitioners in their chosen
specialties. But they are often researchers, too. It may be optional,
but for many, it's the natural outgrowth of the process of learning and
treating, because it's another type of questioning. Here is a glimpse of
some of the research undertaken by UBC's current crop of residents.
01 | It's worth the trip
When rescue workers reach
a victim of hypothermia,
they must often make an
excruciating choice —
transporting them to the
nearest medical facility
or to an advanced medical
facility that is farther away.
Emergency Medicine resident
Doug Brown has helped make
that choice a bit easier.
In a study published in
November in the New England
Journal of Medicine, Dr. Brown
and collaborators from Banff
Austria and Italy reviewed
the medical literature and
concluded that hypothermia
victims whose hearts have
stopped functioning should
be transported to a medical
facility with advanced heart
and lung support equipment,
even if that means longer
travel time.
Cardiopulmonary bypass (CPB)
and extracorporeal membrane
oxygenation (ECMO) remove
carbon dioxide from, and add
oxygen to, a patient's blood,
while supporting their blood
pressure until the heart is
warm enough to pump again.
Dr. Brown's review found that
hypothermia victims in cardiac
arrest have a 50 per cent
chance of surviving if CPB or
ECMO is used, compared to a
survival rate of 0 to 37 per cent
when it isn't used.
"Appropriately equipped
hospitals are more dispersed
here in North America than
in Europe, so transport times
are longer," says Dr. Brown,
an avid mountaineer who
earned his M.D. from UBC,
and is in his final year of
post-graduate training in
Emergency Medicine. "But our
review shows that hypothermic
patients can tolerate many
hours of cardio-pulmonary
resuscitation (CPR) and
still have a good neurologic
outcome. Transporting a
patient to a hospital with
advanced heart and lung
support increases the odds of
surviving hypothermia-induced
cardiac arrest so much, that it's
worth the trip."
The research will help guide
updates to the British Columbia
Ambulance Service Treatment
Guidelines, says John M.
Tallon, the Vice President of
Medical Programs for the B.C.
Emergency and Health Services
Commission. "These insights
would be particularly helpful in
optimizing patient outcomes
in B.C., with our challenging
geography and distances to
critical care centres," he says.
02 | A better predictor for
cardioversion therapy
Atrial fibrillation, a totally
rregular rhythm, is an
epidemic in Canada, with
consequences that include
stroke, heart failure and
cognitive dysfunction.
Cardioversion - a minor
electrical shock to the heart
- can potentially revert this
arrhythmia back into a regular
rhythm. But as many as half of Continued from p9
the patients who receive this
treatment relapse back into
arrhythmia after six months.
Finding a reliable predictor of
success will spare patients
from undergoing a futile
procedure, and lead to better
use of precious health care
resources. One of the most
relied-upon predictors is
the left atrial volume index
(LAVI) — the maximal amount
of blood that resides in the
[eft atrium in relation to the
patient's body surface area.
But Christina Luong, a
second-year internal medicine
resident, wondered whether
right atrial volume (RAVI) is
useful, too.
Under the supervision of
Professor of Medicine Teresa
S.M. Tsang, in the Division of
Cardiology, Dr. Luong analyzed
73 arrhythmia patients who
had been cardioverted at
Vancouver General Hospital.
She found that RAVI was
superior to LAVI in predicting
who will stay in sinus rhythm
after cardioversion, providing 80
per cent accuracy, compared to
LAVI's 67 per cent accuracy.
Dr. Luong, who earned her M.D.
at the University of Alberta,
presented a poster on her
findings atthe American
College of Cardiology's annual
conference in San Francisco
in March.
"It's another way to tell in
advance whether a patient
will likely stay in sinus rhythm
for an extended period, in this
case at least six months," Dr.
Luong says.
03 | A novel approach to
childhood obesity
Childhood obesity is not only
on the rise — it's also very
difficult to treat. Overweight
children often remain so
Christina Luong.
Brenden Hursh.
into adulthood, and weight
management programs have
only a modest effect.
Brenden Hursh, a pediatric
endocrinology resident at
BC Children's Hospital, is
approaching the problem from
a different perspective: If their
weight can't be lowered, can
the negative consequences
of obesity, includingType 2
diabetes, high blood pressure
and heart disease, be
minimized?
Dr. Hursh, under the
supervision of Clinical
Professor Jean-Pierre
Chanoine, is conducting a
collaborative study of 30
children between 1 2 and
18 years-old - half of them
with obesity, half of them of
normal weight - to examine
the interplay between their
nflammatory response and
their autonomic nervous
system (ANS), which controls
nvoluntary functions such
as heart rate, digestion and
breathing.
Obesity has been linked to
higher levels of inflammation.
So the study will describe
the children's levels of
nflammation, as well as the
in vitro reactions of the
children's blood cells in
response to inflammatory
stimulants.
The study also will test the
sympathetic and parasympathetic component of the
ANS, with a focus on the
anti-inflammatory role of the
parasympathetic system. Dr.
Hursh and his colleagues will
examine the variability of the
childrens' heart rates at rest,
and also when performing a
grip-strength test and a mental
test (tracing a star by looking in
a mirror).The children's caloric
consumption during rest also
will be measured.
"If we can show there is a
relationship between ANS
dysfunction and inflammation
in childhood obesity, then
hopefully in the future
we can explore therapies
that specifically target the
autonomic system, and
ward off the obesity-related
conditions that arise as they
head toward adulthood,"says
Dr. Hursh, who earned his M.D.
atthe Icahn School of Medicine
at Mount Sinai in New York and
did his pediatric residency at
the University of Michigan. UBC MEDICINE     11
Karine Khatchadourian.
04 | Filling in the blanks of
gender dysphoria
Gender dysphoria, a feeling
that there is a mismatch
between one's biological
sex and gender identity, has
emerged in recent years as
a genuine medical condition
that deserves treatment. But
the diagnosis is so new, there
is little research to guide
clinicians —and almost all of
it is from Amsterdam.
Karine Khatchadourian helped
to fill in some of the blanks,
with Canadian cases.
A pediatric endocrinology
resident at BC Children's
Hospital, she conducted
a retrospective review of
84 patients, 1 2 to 24 years
old, who were seen bythe
Endocrine Clinic between 1 998
and 2011.The study, she says,
gives clinicians throughout
Canada and the U.S. more
culturally-relevant guidance for
treating gender dysphoria.
Dr. Khatchadourian, under
the supervision of Clinical
Professor Daniel Metzger,
examined a variety of issues,
ncluding: how many came to
be seen by specialists, and
at what age: the prevalence
of mood and anxiety
disorders: how many opted
to take puberty-blocking
medication, and later, cross-
hormone treatment to switch
their genders.
One other more intriguing
findings, presented at the
Endocrine Society's annual
meeting in 201 2, was that
only one patient out of the 27
who went on puberty blockers
didn't follow through with the
transition to another gender.
Dr. Khatchadourian sees this
as validation of using puberty-
blockers as way of smoothing
the transition.
Dr. Khatchadourian, who
earned her M.D. and did her
pediatric residency atthe
University of Montreal, found
that the patients had a much
higher percentage of mood
and anxiety disorders than the
general adolescent population.
On a more encouraging note,
she also found that many of the
male-to-female patients chose
to bank their sperm before
proceeding with the transition.
"That shows you can have
meaningful discussions about
fertility with 1 6-year-olds," Dr.
Khatchadourian says.
05 | A warning sign of a high-
altitude hazard
There is no cure for acute
mountain sickness, other than
going back down. So being able
to predict one's susceptibility
to the condition — which
ncludes difficulty sleeping,
dizziness or light-headedness,
fatigue, headache, loss of
appetite, nausea or vomiting,
and shortness of breath - has
obvious usefulness for anyone
contemplating that life-
changing ascent up Everest.
Paul Hertz, a second-year
general internal medicine
resident, worked with Michael
Koehle, an Assistant Professor
in the Division of Sports
Medicine and the School of
Kinesiology, to see if balance
perform a simple, 3-minute
balance test at sea level and
various altitudes, as high as
4,500 metres. (Everest, by the
way, is 8,848 metres high.)
Their hypothesis:The raw score
isn't useful, because balance
- even at sea level - can vary
from one person to the next.
What matters is how much a
person's balance worsened as
they go higher.
Half of the 12 subjects
developed acute mountain
sickness, giving the researchers the basis they needed to
test their theory. The results
are now being prepared for
publication.
"I've just always been
nterested in pushing the
limits of human physiology,"
The hypobaric chamber at Simon Fraser University, photo credit: an drew
3ILLATT/CICADA STUDIO
- more specifically, a loss of
balance between sea level and
higher altitude - can serve as
that telltale sign.
Working at Simon Fraser
University's hypobaric chamber,
Dr. Hertz, Dr. Koehle and others
asked research volunteers to
says Dr. Hertz, who earned
his M.D. at Queens University.
"As physicians, we're focused
on getting sick people back to
normal. But it's also interesting
to flip that, and take normal
people and push them into the
exceptional range." FOCUS ON:
l TMifiTimi
DICINE AT
(ARIES 0
HE WOR
y
^natural beauty, and the rich history a..,
people who call it home, have long lured travelers. For the medical
residents who rotate through this archipelago, it's an assignment
unto itself. d 1
Cam Grose, a second-year UBC resident; Clinical Instructor Michele Leslie, photo credit: danielpresnell
Separated from British Columbia's mainland by the fierce
currents of the Hecate Strait, and often shrouded in dense fog
and mist, it is easy to see why the Haida people refer to the small
set of sylvan islands as "Xaadala Gwayee"—the islands at the
boundary of the world.
When the fog lifts on Haida Gwaii, the golden sunlight bounces
off the water, illuminating the dense spruce and pines lining the
coast. The natural beauty of these remote islands, and the rich
history and art of the Haida people who call it home, have long
lured travelers willing to make the journey.
But for a young doctor in training, this place brings a particular set
of challenges. The closest CTscan is in Prince Rupert, an eight-
hour ferry ride away. Managing a seriously ill or injured patient
often involves considerations that most residents never confront
—such as the weather.
"If someone can't be handled here, we have to get them off-
island, and it's not just a matter of getting the plane and getting
them on board,"says Cam Grose, a second-year UBC resident in
family medicine, in the midst of an eight-week rotation on Haida
Gwaii. "There can be long delays due to weather conditions, plane
availability, logistical challenges and managing them here in the
nterim. And anytime I'm asking to put three people in the air, there
is an added element of risk!'
The limited availability of lab tests and resources, the logistical
challenges of practicing medicine in a remote location, and the
cultural skills required to care for a largely Aboriginal population
combine to make the family medicine residency rotation in Haida
Gwaii an assignment unto itself.
All family medicine residents must complete an eight-week
rotation in a rural community in British Columbia. Haida Gwaii, an
archipelago of two main islands and 1 50 smaller ones, has been
one of the options for over 20 years, and has become one of the
most sought-after.
"The rotations on Haida Gwaii give residents access to Aboriginal
health issues, the doctors and health professionals have great
reputations, and it is a beautiful place to visit,"says Willa Henry,
the Program Director of the Family Practice Postgraduate Program.
One stop for most residents is the Northern Haida Gwaii Hospital
and Health Centre in Masset, on the northern tip of Mooresby
Island, where on a clear day one can seethe outline of Alaska in
the distance.
Clinical Instructor Michele Leslie, a family physician based there,
strives to ensure that the education extends beyond the clinic's
walls. Supported by a Faculty of Medicine Special Populations
Fund grant, she provides "cultural safety" training for residents,
assigning readings on the history and impact of residential
schools, and encouraging participation in Aboriginal community
events, so that residents gain some context and can communicate
more effectively.
"Being culturally aware and sensitive to subtle aspects of how
they communicate, and what are faux pas or not, can make a
big difference, especially when you are talking to elders about
their care," says Matt Menard, a veteran of the Haida Gwai
residency rotation, who has since returned for a "locum," or
temporary assignment.
Dr. Menard's return to the scene is typical.
"For every resident that has come here to train, everyone has
come back to do a locum as a staff physician here," Dr. Leslie
says. "I really feel that is a testament to the positive experience
they have as learners, and the pull of this place. People fall in
love with it!'
That was certainly the case for Dr. Grose, whose first encounter
with Haida Gwaii came in his fourth year in UBC's Northern
Medical Program, when he spent a month in Queen Charlotte City.
"The exposure to the doctors, and being a part of the health care
community, solidified my decision to pursue rural family medicine,"
he says.
Now back as a resident, Dr. Grose is taking on a more independent
role - managing patients with the health care team, and learning
to optimize resources, such as telemedicine - to help his
transition to independent practice this summer.
At Friday morning rounds, Dr. Grose joins his physician colleagues,
members of the nursing staff, and community support workers at
the Queen Charlotte Islands General Hospital to discuss patients,
health care and other community issues in such villages asTlell,
Sandspit, Skidegate and Port Clement.
"It's not just the training, but the connections you make within the
community," Dr. Grose says. "It's the patients you see, the problem-
solving, the strategizing that you are exposed to throughout the
training. Those are the pearls that don't necessarily relate to
medicine per se, but do relate to future practice!' 01 | Another culprit for
obesity:Too much insulin
■ A serendipitous
I discovery by
»■«'    "    Associate
m^^ Professor
I James Johnson
could overturn widely accepted
notions about healthy eating
habits.
The study, published in Cell
Metabolism, examined the
role of insulin, the hormone
that allows the body to store
blood sugar for later use as an
energy source. Dr. Johnson,
in the Department of Cellular
and Physiological Sciences,
gave a high-fat diet to two
groups of mice: A control
group of normal mice and
another group bred to have
half the normal amount of
nsulin.
The control group, as expected,
became fat. But the low-insulin
mice were protected from
weight gain because their fat
cells burned more energy and
stored less.The lean mice also
had less inflammation and
healthier livers.
Dr. Johnson concluded that
extra insulin produced in the
normal mice bythe high-fat
diet caused their obesity, which
strongly suggests that mice
- and, by extension, humans
- may make more insulin than
they need.
The findings may mean that the
key to maintaining a healthy
weight is to continually return
nsulin levels to a healthy
baseline by extending the
gaps between meals and
ignoring the widespread
recommendations to consume
small amounts throughout the
day. In other words, cut out the
snacks — and make sure not to
overcompensate at mealtime.
"As crucial as insulin is for
storing blood sugar, it can
also be too much of a good
thing," Dr. Johnson says. "If we
can maintain insulin levels
at a happy medium, we could
reverse the epidemic of obesity
that is a risk factor for so many
ailments — diabetes, heart
disease, and cancer."
While existing insulin-blocking
drugs could prevent weight
gain, they carry serious side
effects that outweigh their
benefit. Further research might
lead to drugs that block excess
nsulin production or blunt
its effect on certain targeted
tissues. Dr. Johnson also has
plans to study a number of
different diet types to determine
which approach is most effective
at maintaining healthy insulin
levels.
02 | Grading the graders
a
The best gift
you can give
a stand-up
comedian is
to subject
his audience to an atrocious
warm-up act. Kevin Eva showed
that the same is true for
medical residentsA
Dr. Eva, a Professor a\d Director
of Educational Research and
Scholarship in the Department
of Medicine, worked with \
researchers at the UniversifV
of Manchester to see if clinical
educators' grading of younger
doctors could be influenced by
the quality of those they had
previously evaluated.
In the study, published in
JAMA, physician-educators
in England and Wales were
asked to grade videos of young
doctors in their first year of
post-graduate training.The
trainees in the videos followed
scripts representing three
levels of perfo/mances - good,
poor, and bo/ierline - as they
nterviewed and examined
actors portraying patients.
Some educators were
"primed" by viewing the good
performances while others viewed the poor performances.
Then both groups were
compared on their grading of
the borderline performances.
Educators who had been
primed by poor performances
consistently gave better
grades to the borderline
performers than those who
had just watched the good
performances. Depending on
the patient case, the grades
were 30 per cent to 100 per
cent better.
"This experiment shows
that judging someone's
performance - whether it's
clinical skills, essay-writing,
or figure skating - is likely to
be relative, and that we can't
assume that examiners are
working from a fixed, absolute
standard, as is expected in
current models of education,"
says Dr. Eva, a Senior Scientist
at UBC's Centre for Health
Education Scholarship.
"While such assessments are
unavoidable in determining
whether a student has
mastered the required
competencies in a field like
medicine, we need to take
steps to minimize contrast
bias — perhaps by continually
mixing up the order of the
people being examined," Dr. Eva
says. "This is one of the reasons
it is important to ensure that
there are a sufficient number
of evaluations — the more data
points, the more reliable the
aggregate score will be."
03 | A self-propelled coagulant
Christian Kastrup, an Assistant
Professor in the Department
of Biochemistry and Molecular
Biology, has invented a
mechanism for getting blood-
clotting treatments to the
source of bleeding.
Dr. Kastrup's idea involves
micro-sized coagulant particles
that are surrounded by a
water-sensitive propellant,
which releases gas and energy
when it comes into contact with
blood.The resulting reaction
drives the particles at a high
velocity (more than 10 cm/
sec) upstream against the flow
of blood, potentially allowing
them to penetrate deep into
areas of bleeding— particularly
post-partum, but also in cases
of trauma.
"If we put these particles onto
a wound, the particles will fly
all over, including upstream
through blood, to the site of the
hemorrhage, where they can
stop bleeding from occurring,"
says Dr. Kastrup, who also is a
member ofthe MichaelSmith
Laboratories and the Centre for
Blood Research.
With a $100,000 grant from
the federally-funded Grand
Challenges Canada, Dr. Kastrup
plans to use animal models
to determine the optimal
combination of propellant
and coagulant, and the
optimal size ofthe particles
necessary for penetrating
deep into areas of bleeding
without entering the circulatory
system. He will also produce
a feasibility study showing
how this topical treatment
can be distributed and used
by non-experts in developing
countries, presumablythrough
commercial partners.
"It will have simple instructions,
such as, 'If you see a lot of
blood, pour powder over the site
of bleeding,'" Dr. Kastrup says.
04 | The lingering damage of
concussions
Concussion-related changes
to brain structure and function
persist well beyond the initial
trauma — leaving open the
possibility that adolescent
athletes could be returning
to sports before their brain
njuries have fully healed.
In a study published in Pediatric
Neurology, Faculty of Medicine
researchers used advanced
maging and a common
concussion assessment
technique to examine brain
structure and function in a
dozen adolescents who had
experienced at least one
sports-related concussion
in the previous two months,
and compared them with
10 otherwise healthy, non-
concussed adolescent athletes.
"The imaging results, which
captured the movement of
water through the brain, showed
thatthe integrity of white matter
was significantly different
between the concussed and
non-concussed teenagers,"
says Naznin Virji-Babul, an
Assistant Professor in the
Department of Physical
Therapy and a scientist in the
Brain Research Centre and
the Child & Family Research
Institute. Postdoctoral fellow
Michael Borich analyzed the
brain scans.
The brain images, Dr. Virji-
Babul says, "were strongly
associated" with results from
the concussion assessment
test, which is used on playing
fields and in clinical settings,
and measures 22 symptoms,
ncluding balance, orientation
and memory. But coaches and
trainers sometimes dismiss or
downplay negative results from
such assessments.
"Our research has immediate
mpact on return-to-play
decisions made by physicians
and medical personnel,
coaches, parents, and the
athletes themselves," says
co-author Lara Boyd, a
Canada Research Chair in the
Neurobiology of Motor Learning
and also a member ofthe Brain
Research Centre. "We need age-
specific diagnostic guidelines
that are applied consistently
across the disciplines of
neurology, physical medicine,
rehabilitation, and sports
medicine."
The researchers are planning
future studies to understand
the risks of returning to play
and to develop improved
clinical practice guidelines in
physicians' management of
sports concussions. David Liu explains the finer points of a radioembolization on a patient with liver cancer, photo credit: don erhardt
CUTTING EDGE, WITHOUT THE CUTTING
Interventional radiology (IR) is among the youngest of medical
fields, dating only to the 1960s, when Portland's Charles Dotter
invented angioplasty and the catheter-delivered stent. Owing to
its novelty and its reliance on technology, IR is one of the most
rapidly-evolving medical subspecialities.
Dave Liu is riding that wave's leading edge.
"We're trying to develop as many small, precise,
elegant hammers as we can,"says Dr. Liu,
a Clinical Associate Professor who trained
in interventional radiology at Northwestern
University in Chicago, then worked in Los
Angeles, Portland, and Spokane before returning
to Canada in 2008.
IR is becoming a less risky complement to surgery, since many
of its procedures are done through a small incision, guided by
advanced imaging technologies such as ultrasound, computed
tomography, magnetic resonance imaging, and x-ray cameras.
Sometimes, IR is a patient's only hope because a tumour's growth
or placement has made it impossible to remove through surgery, or
because drugs have proven ineffective.
One of only 11 physicians in Canada to be inducted as a fellow in
the Society of Interventional Radiology, and this year's winner of
the Young Investigator Award from the Canadian Association of
Radiologists, he also holds a clinical faculty appointment atthe
David Geffen School of Medicine atthe University of California, Los
Angeles.
He gives 40 to 50 lectures a year around the world, and is the
driving force behind the Symposium on Hepatic Oncology at
Whistler (SHOW), which held its second annual meeting in
February, drawing 178 people from such institutions as the Johns
Hopkins University and Duke University, and from as far away as
Scotland and Australia.
Like most interventional radiologists, Dr. Liu's repertoire spans a
wide range of conditions: pulmonary tumours, varicoceles in the
scrotum, uterine fibroids, clot-induced leg swelling, pain relief
for cancer patients, even emergency reconstruction of damaged
aortas. But his work on SHOW reflects his particular expertise and
leadership in using IR techniques to treat liver cancer.
One ofthe most advanced therapies he uses to treat the condition
is radioembolization — the injection of radioactive particles into
the vessels that feed the growing tumour. The particles lodge in
the vessels, emitting radiation over several weeks: angiography is
used to make sure the isotopes are placed in the precise spot.
"Mother nature has provided us, through the process of
angiogenesis, with a conduit that leads directly into the heart of
the tumor," says Dr. Liu, who brought the technique to the West
Coast. "It's so focused and targeted that the normal part ofthe
liver continues to function with only a mild degree of temporary
nf lamination, while the tumor is subject to lethal amounts of
radioactivity."
Dr. Liu is pushing hard to keep the innovation going, and is heavily
nvolved in clinical research trials, including one testing the
effectiveness of injecting and infecting tumours with genetically
modified viruses that trigger the body's own immune system to
attack cancer cells. Vancouver is one ofthe 1 5 trial sites around
the world.
Another study is seeking to determine the optimal size and
composition of drug-eluting beads that release chemotherapy
drugs into the tumour's blood vessel network. He also is the
Co-Chair and Co-Founder of a national expert panel exploring the
best practices for management of deep vein blood clots in the legs.
Most recently, he has begun a collaboration with colleagues
Anna Cellerand Francois Benard in the Department of Radiology
and Urs Hafeli in the Faculty of Pharmaceutical Sciences to
develop the next generation of radioactive microparticles for liver
cancer that are more visible, more accurate, and more easily
administered.
"Better, safer, faster — that's basically what we're trying to do, so
more hospitals can institute our techniques and ultimately, more
patients can benefit from what IR has to offer," he says. ffl
W        i
\i
1/
' r
Ni
Gillian Taylor, a first-year audiology student, gets an up-close glimpse of Moe the Mouse.
DHOTO CREDIT: DON ERHARDT
VOYAGES OF DISCOVERY, CLOSE TO HOME
As Europeans colonized Canada's western coast, the uncharted
wilderness slowly yielded its secrets to explorers, trappers,
miners and cartographers. But understanding of the indigenous
peoples always lagged behind Europeans' knowledge ofthe land,
and still does.
Professor of Speech-Language Pathology
May Bernhardt discovered one such area of
uncharted cultural understanding several years
ago — in her own specialty.
When, atthe urging of a development
psychologist, Dr. Bernhardt began exploring how
child language development was being evaluated and treated
in Aboriginal communities, she realized how much she and her
students had yet to learn.
The result was a new course, and one of UBC's most concerted
efforts at fostering Aboriginal understanding: "Approaches to
Speech Language Pathology and Audiology for People of First
Nations, Metis and Inuit Heritage." Of the 11 Canadian universities
that offer degrees in audiology or speech-language pathology
only UBC has such a course.
"We realized our students didn't know anything about First
Nations communities — they were either afraid, or didn't know
what to do," Dr. Bernhardt says. "And the communities were wary
because we were overdiagnosing kids in those communities with
language difficulties, based on norms developed in the middle-
class United States!'
The course's premise is that language is a crucial component
of identity— how we speak, and how we process what he hear,
depends largely on who we are. So determining if someone is
having trouble speaking or hearing, and working to remediate
real or perceived deficiencies, must take into account cultural
differences between the examiner and the examined.
For example, children who are being evaluated for potential
speech problems are, of course, asked to speak. But one-on-
one conversations with an adult may not feel natural to many
Aboriginal children, who are often encouraged to learn by listening
and observing.
Aboriginal children also may use a dialect of English from their
community, which can deviate from the "standard English" used by
speech-language pathologists.
"When does a child have an actual problem, and when is it just
a problem in the mind ofthe examiner or school? We're just
beginning to figure that out," Dr. Bernhardt says.
Speech-language pathology and audiology students learn
about the history of residential schools: create artwork, perform
dramatic readings or create journals of reflection: and learn
culturally-sensitive techniques and strategies, such as using
group story-telling for speech evaluations, instead of one-on-one
conversations.
Another technique is Moe the Mouse, one of a dozen stuffed
animals created by two B.C. speech language pathologists as a
way of drawing out pre-school Aboriginal children during speech
evaluation and therapy sessions. Each animal represents a
different sound.
Audiologists have taken up Moe as well — every time the child
hears a tone in a headphone, Moe deposits a nut in a "tree"
(actually, a milk carton).
"You have to draw their attention to something that is more tangible
to their culture,"says NavidShahnaz, an Associate Professor of
Audiology and a course co-instructor. "Moe the Mouse is a good
way to make that connection and establish a good rapport. If
children are scared of you, they're not going to respond to the beep,
and they're not even going to let you put those headphones on."
But the most popular part of the course is the community
learning experience, in which students spend time with agencies,
organizations or individuals providing services to Aboriginal
communities, and report back to the instructors and their fellow
students on their activities and insights.
"You can't read about cultural safety and sensitivity," Dr. Bernhardt
says. "You have to do it." ENHANCING EXCELLENCE
NEW ARRIVALS
"HE FACUE
[]To use simulation technology to improve training for the
entire health care team, so patients receive kinder, gentler
and more efficacious care.
I]To enhance exercise capacity and reduce shortness of breath in
patients with chronic respiratory conditions.
EDUCATION: BachelorofScience,
University of Alberta; M.D., University
of Calgary; Family Practice Residency,
Holy Cross Hospital, Calgary; Urology
Residency, University of Ottawa;
Extracorporeal Shockwave Lithotripsy
& Endourology Fellowship, Washington
University School of Medicine, St.
Louis; Masters in Health Profession
Education, University of Illinois at
Chicago.
PREVIOUS POSITION: Professor of
Urology, Director of Surgical Education
Institute, and Associate Dean of
Simulation and Continuing Medical
Education, University of California
rvine School of Medicine.
DISTINCTIONS: Chair.Amencan
Urological Association (AUA) Office of
Education; Chair, AUALaparoscopy
Committee; Coordinator, AUA Ad
HocSurgicalSimulation Group;
member of editorial boards of Journal
of Endourology and the Journal of
the Society of Laparosndoscopic
Surgeons; past president     and
recipient of Excel Award from, Society
of Laparoendoscopic Surgeons;
Excellence In TeachingAward from the
UC Irvine Department of Urology.
DIDYOD KNOW?: She has toured
the Rajastan desert of India, the
Hungarian and French countryside,
and the coffee and rubber plantations
of Brazil — all on horseback.
EDOCATION: Bachelor's degree in Exercise
Science, Master's of Science and PhD in
Exercise Physiology, UBC.
PREVIOOS POSITION: Postdoctoral Fellow,
Queen's University School of Medicine,
Respiratory Investigation Unit.
DISTINCTIONS: Providence Health
Care Research Institute and St. Paul's
Hospital Foundation New Investigator
Award; Canad I an Thoracic Society and
Canadian LungAssociation Postdoctoral
Fellowship; NaturalSciences and
Engineering Research Council (NSERC)
Postdoctoral Fellowship; John Alexander
Stewart Postdoctoral Fellowship
(Queen's University School of Medicine);
CIHR Institute ofGender and Health
Award of Excellence; Governor General's
Academic Gold Medal; Senior and Junior
Graduate Trainee Award, Michael Smith
Foundation for Health Research; NSERC
Postgraduate Scholarship;Sir James
Lougheed Award of Distinction; Faculty
of Education Valedictorian; Outstanding
Service Award, Himalayan Rescue
Association.
DIDYOD KNOW?: When he's not in the lab
he can usually be found training for the
Grouse Grind Mountain Run. His fastest
time up "Mother Nature's Stairmaster"
is 28:20.
"Simulation-based education is widely accepted as an effective
and efficient way for students and health professionals to learn.
As the new Provincial Coordinator for Health Simulation Education,
I will bring together the various players in simulation across the
province to assess existing resources and capabilities, and to
develop and implement a comprehensive program that meets the
learning needs of all health care students, trainees and workers.
I plan to help all simulation instructors reach a consistent level
of expertise in this educational modality, develop standardized
curriculum and practice scenarios for undergraduate, graduate and
continuing education, and set up outreach from and between the
various provincial medical learning centres. I will foster research to
determine how to make simulation-based education more effective
and efficient, and thereby improve the quality and outcomes of
health care for British Columbians."
"Chronic obstructive pulmonary disease (COPD), a debilitating and
degenerative disease that is caused primarily by smoking, is the fourth
leading cause of death worldwide and accounts for the highest rate of
hospital admissions among major chronic illnesses in Canada. Shortness
of breath is the hallmark symptom, causing patients to avoid physical
activity resulting in cardiovascular and muscular deconditioning.This
downward spiral caused by physical inactivity progresses relentlessly
to the point where COPD patients are unable to perform basic activities
of daily living. The goal of my research program is to identify the
physiological mechanisms of shortness of breath so that we can
develop more effective interventions to enhance exercise capacity and
reduce symptoms in patients with COPD. The Cardiopulmonary Exercise
Physiology Laboratory at St. Paul's Hospital assesses the respiratory,
cardiovascular, muscular and neurophysiological responses to exercise,
so that we can identify the complex mechanisms of shortness of breath
and exercise intolerance in humans. Based on this knowledge, we can
then develop and test novel therapeutic interventions to target these
mechanisms to enhance exercise tolerance, reduce shortness of breath
and ultimately improve quality of life for those suffering from chronic
respiratory diseases." []To enrich the quality of life of patients and bend the cost curve
of chronic respiratory conditions in Canada and beyond
% AGE: 36 POSITION: Assistant Professor of Health Economics,
rf/^^    Division of Respiratory Medicine, Department of Medicine;
V/^v Scientist, Centre for Clinical Epidemiology and Evaluation,
Vancouver Coastal Health Research Institute
IN MEMORY OF CLYDE HERTZMAN
1953-2013
EDOCATION: M.D.Tehran University of
MedicalSciences; Master of Health
Sciences, Epidemiology, UBC; PhD,
Outcome Sciences, UBC.
PREVIOOS POSITION: Health Economist,
Centre for Clinical Epidemiology and
Evaluation, Faculty of Pharmaceutical
Sciences and Collaboration for Outcome
Research and Evaluation, UBC.
DISTINCTIONS: Canadian Institutes
of Health Research (CIHR) Fellowship
Award;CIHRBisbyFellowshipPnze;UBC
Four-Year Fellowship Award.
DIDYOD KNOW?: An astronomy buff, he
is chronicallyfrustrated byVancouver's
cloudyskies, and compensates by
reading articles and books, and watching
documentaries, about red dwarfs, black
holes and quasars.
"Chronic respiratory conditions, namely asthma and chronic obstructive
pulmonary diseases (COPD), impose tremendous financial and
humanistic burdens on individuals and society. COPD is projected to
become the third-leading cause of death across the world in the next
few years. Currently, respiratory diseases rank third as the major cause
of hospitalization worldwide, behind circulatory and digestive disorders.
Asthma is an especially significant burden in Canada, accountingfor
approximately 80 per cent of chronic respiratory disease. In a world
of budget deficits and increasing health care costs, our scarce health
care resources must be allocated on the basis of an objective and
rational framework. Such a framework would translate the impact of
technologies for the prevention, diagnosis, and treatment of disease
into policy-relevant indices, such as costs and quality of life. I have
dedicated my career as a health economist to addressing the pressing
need to control the rampant cost of chronic diseases. I am finding ways
to keep the soaring cost of chronic respiratory diseases under control,
while ensuring the delivery of high-quality care to individuals."
Clyde Hertzman - Professor in the School of Population
and Public Health, and one ofthe most distinguished and
dedicated members ofthe Faculty of Medicine - died
suddenly while in London, U.K., in February. He was 59.
Dr. Hertzman, as the Director of the Human Early Learning
Partnership and Canada Research Chair in Population
Health and Human Development, played a central role in
delineating the special role of early childhood development as
a determinant of health. Throughout his career, he gathered
scientific evidence to show that early life experiences affect
a child's brain and social development, their genes and their
ability to thrive. His research has informed initiatives for
healthy child development at the international, national,
provincial, and community levels.
He joined UBC in 1985, and went on to earn some ofthe
country's highest honours. In 2010, he was named "Health
Researcher of the Year" bythe Canadian Institutes of Health
Research. Shortly before his death, he was appointed to the
Order of Canada, and was posthumously awarded a Queen
Elizabeth II Diamond Jubilee Medal in February. He was a
Fellow of the Royal Society of Canada and the Canadian
Academy of Health Sciences.
"His energy, enthusiasm and irrepressible spirit were so great
as to become an integral part ofthe Faculty of Medicine's
very identity, and it will leave a permanent imprint on us as
individuals, and on our institution"wrote Gavin Stuart, Dean
ofthe Faculty of Medicine and UBC's Vice Provost Health, in a
letter to the community. "While it is sobering to contemplate
how much work he had left in him, we must take solace in how
much Clyde accomplished - not only as a scholar, but also in
his personal dealings with friends and loved ones"
Dr. Hertzman's family and the Human Early Learning
Partnership organized a "Celebration of Life" in his memory
on March 17 at the Chan Centre for the PerformingArts on the
UBC campus. The university also created the Clyde Hertzman
Legacy Fund; for more information, visit http://bit.ly/hertzman
or find it through http://startanevolution.ubc.ca/ L - R: Martin Gleave, Peter von Dadelszen.
PHILANTHROPISTS BET ON THE FACULTY OF MEDICINE
FOR LIVE-SAVING SOLUTIONS
Although the Canadian government is the largest single source of
the Faculty of Medicine's research funding, its various granting
agencies are understandably wary of unconventional ideas. That
is often where private foundations step in.
Philanthropists can take a chance on a risky idea with the
potential for high reward — an innovative solution that can
transform the way we fight a disease, saving or improving millions
of lives. As Warren Buffetttold Bill and Melinda Gates, "Don't just
go for safe projects. Take on the really tough problems.''
In 2011-201 2, 23 per cent ofthe $292.6 million in peer-reviewed
grants received bythe Faculty of Medicine came from private
philanthropic organizations.
The Faculty of Medicine has emerged as a competitive force
in the national and international arenas ofthe major private
charitable granting groups. Late in 201 2, three substantial
peer-reviewed grants were awarded to Faculty of Medicine
nvestigators bythe Bill and Melinda Gates Foundation, the
Prostate Cancer Foundation with Stand Up To Cancer, and the
National Sanitarium Association.
The Faculty of Medicine's highly collaborative research
environment and the creativity of our clinician-researchers is a
winning combination," says Howard Feldman, Executive Associate
Dean, Research. "Philanthropy allows us to push ahead even
further to conduct game-changing research that transforms
patient care locally, nationally and globally."
In November, the Faculty of Medicine received an additional
$17 million from the Bill & Melinda Gates Foundation - on
top of $7.4 million awarded bythe foundation in 2010 - for
a project aimed at finding and treating women at risk of
succumbing to pre-eclampsia, the often-fatal onset of high
blood pressure during pregnancy.
Led by Petervon Dadelszen, Professor in the Department of
Obstetrics and Gynecology, this project is testing a low-tech,
iow-cost method for diagnosing pre-eclampsia and assessing
the degree of risk, based on a woman's symptoms and a physical
examination.The goal is to remedy a glaring inequity: almost all of
the 76,000 women who die annually from pre-eclampsia live in the
developing world.
In October, the Prostate Cancer Foundation and Stand Up To
Cancer awarded $10 million to a multi-centre "dream team" of
more than 30 investigators at the Vancouver Prostate Centre, the
University of California and the Oregon Health Sciences Centre.
The Vancouver Prostate Centre, the only Canadian site chosen
to be part of the team, will use advanced genomics to study how
prostate cancers adapt and overcome treatment therapies. Led
by Martin Gleave, Distinguished Professor in the Department of
Urologic Sciences, they will then design combination treatments
that target the pathways the cancer cells are using, reducing the
cells'chances of survival.
In December, the National Sanitarium Association added another
$1 million to the nearly $5 million it has granted to the Faculty
Stephen Lam.
of Medicine to speed the discovery of effective treatments for
chronic respiratory diseases that affect hundreds of millions of
patients worldwide.
With this most recent grant, Stephen Lam, Professor in the
Division of Respiratory Medicine, is leading the development of a
rapid screening technology to identify effective treatments.
"We think of ourselves as venture capitalists looking to kick-start
nnovative, high-risk research projects that have a potentially high
pay-off," says William Acton, President of the National Sanitarium
Association, which funds respirology research. "We hold an annual
call for proposals Canada-wide, and UBC frequently comes out on
top of our scientific review process, which reflects the quality of
the work you're doing." L-R: Adam van Koeverden; UBC President Stephen J. Toope (left) and Sun Life Financial Canada President Kevin Dougherty.
DHOTO CREDITS: CANADIAN OLYMPIC COMMITTEE (VAN KOEVERDEN), JOH N SMEE (SUN LIFE;
OLYMPIC AMBITIONS-BOTH ATHLETIC AND MEDICAL
On a chilly January afternoon in London, two high-profile
Canadians - a champion sprint kayaker and a leading UBC
neuroscientist - met at Canada House, the High Commission
of Canada in the United Kingdom. They were soon joined by
UBC alumni and members of the London neuroscience and
business communities.
They had come to discuss elite
athleticism. But their larger mission was
honouring the legacy of investor and
philanthropist PeterCundill.
Cundill completed 22 marathons
before he was diagnosed with Fragile
X-associated tremor/ataxia syndrome
— a rare, untreatable neurodegenerative
disease with symptoms similar to
Parkinson's. After his death in 2011, the
Peter Cundill Foundation donated $6 million to the Faculty of
Medicine for Parkinson's research, with an agreement that the
Faculty would host a series of annual lectures.
January's inaugural lecture in London featured Adam van Koeverden,
who told his personal story of how determination and years of
training transformed him from a child with no apparent athletic
talent into a record-breaking Olympian, and MaxCynader,
Director ofthe Brain Research Centre and the Djavad Mowafaghian
Centre for Brain Health, who explained how modern neuroscience
is helping elite athletes enhance their grit, focus, teachability
and adaptability.
Since the Foundation's most recent gift in April 201 2,
Matthew Farrer and UBC's Parkinson's team have identified
a third gene linked to this disease.
"Understanding that diseases ofthe brain represent one ofthe
greatest challenges to global medical health in the 21st century
the Peter Cundill Foundation's decision to support the UBC
Faculty of Medicine was simple,"said Peter Webster, a Foundation
Trustee, at the London lecture. "UBC is a world leader in the field of
neuroscience and brain health research. We have already begun to
witness the impact their work is making on Parkinson's and other
neurological diseases, and we continue to be inspired and hopeful!'
SELF-HEALTH: sun life supports online risk assessment tool
Faculty of Medicine experts in men's health, women's health and
eHealth are collaborating- with funding from Sun Life Financial
- to equip Canadians with a tool to assess their risk of developing
common illnesses over the next 10 years.
The online questionnaire will ask users approximately 17
questions about their lifestyle, family history and medical
status. In the background, an algorithm designed bythe UBC
team will weigh and rank their answers against risk factors for
various illnesses.
The tool will deliver tailored recommendations to help
Canadians be pro-active, rather than reactive, about their
health. For example, men in their late teens and early 20's will
[earn to self-examine their testicles once a month.Testicular
cancer is curable if found early.
"The goal is for men and women who are at higher risk of illness
to seek appropriate advice on prevention and early detection.This
will ultimately have huge downstream benefits on health, society
and health economy," says Larry Goldenberg, Professor and Head
ofthe Department of Urologic Sciences, who is working on the tool
with Sarah Finlayson, Assistant Professor in the Department of
Obstetrics and Gynecology, and Kendall Ho, Director ofthe UBC
eHealth Strategy Office.
Sun Life Financial donated $246,000 to the Faculty of Medicine
to develop and launch the online questionnaire. A marketing and
outreach plan is underway to launch the men's tool this year,
and the women's tool in 2014.
"Canadians who have a better understanding of their health risks
can curb further complications down the road. We've seen this
first-hand through our workplace health and wellness programs,"
says Kevin Dougherty, President of Sun Life Financial Canada.
"Our major health sponsorship focus in Canada is diabetes, so
we're proud to fund the University of British Columbia's initiative,
which encourages Canadians to take action on their health - a
critical step in preventing and managing diabetes and other
serious illnesses." 22     UBC MEDICINE
IAKING A MARK:
ACHIEVEMENTS & AWARDS
Xuesen Dong,
an Assistant
Professor in the
Department of
Urologic
Sciences, has
been named one of four grant
recipients in the inaugural
Rising Star in Prostate Cancer
Research program of Prostate
Cancer Canada.
Dr. Dong, who conducts his
research at the Vancouver
Prostate Centre, will focus on
androgen receptor signaling in
castration resistant prostate
cancer.The "RisingStars"
program allows research
scientists in the first five
years of their first academic
or research appointment to
work under the guidance of
an experienced mentor. Each
recipient receives a grant of
$150,000 a year for salary
support and research expenses,
for a period of three years.
Three faculty members have
received 2013 Certificate of
Merit Awards from the Canadian
Association for Medical
Education (CAME):
I   Steven Chang,
Clinical
Instructor
in the
Department
V   Y   <    I    of Family
Practice, and Course Director,
Clinical Skills in the Northern
Medical Program.
Paul Kliffer, Clinical Professor
in the Department of Anesthesiology, Pharmacology &
Therapeutics.
J/7/ McEwen, Clinical Associate
Professor, Undergraduate
Education Program Director
and Clerkship Director for Years
3 & 4 in the Department of
Emergency Medicine.
«        David
Scheifele, a
*     Professor in the
Department of
Pediatrics, was
appointed to
the Order of Canada.
Dr. Schiefele is Director ofthe
Vaccine Evaluation Centre,
which conducts disease burden
studies, vaccine clinical trials,
and studies to fine-tune public
immunization programs,
ncluding ongoing assessment
of vaccine safety.
Dr. Scheifele also is co-leader
ofthe Public Health Agency of
Canada/Canadian Institutes
of Health Research Influenza
Research Network (PCIRN),
responsible for clinical trials.
PCIRN was established in
2009 to prepare for necessary
nvestigations during an
nfluenza pandemic and was
quickly re-tasked to focus on
the H1N1 pandemic.
Clyde Hertzman also was
appointed to the Order of
Canada, shortly before his
death in January. See article on
page 19.
Dianne Miller
an Associate
Professor in
the Department of
h    1 Obstetrics &
Gynaecology, received the Terry
Fox Medal from the British
Columbia Medical Association
(BCMA) in recognition of her
outstanding leadership in the
ovarian cancer field.
Dr. Miller was instrumental
in co-founding the Ovarian
Cancer Research Program
(OvCaRe) at the BC Cancer
Agency and Vancouver
General Hospital, which has
successfully brought together
a team spanning multiple
specialties.Their initiatives
nclude spearheading a major
practice change involving
fallopian tube removal, which
will reduce deaths by ovarian
cancer by up to 50 per cent
over the next 20 years in B.C.
Judy Hies,
Professor of
Neurology in
the Department
•fl^F '    of Medicine,
was named a
Fellow of the American Association for the Advancement of
Science (Section on Neuroscience) and a Fellow ofthe Royal
Society of Canada.
Dr. Illes was recognized for
her leadership in neuroethics
— an interdisciplinary field
dedicated to the ethical, legal,
social and policy implications
of advances in neuroscience.
A Canada Research Chair in
Neuroethics and Director of the
National Core for Neuroethics
at UBC, she also holds affiliate
appointments in UBC's School
of Population and Public Health
and School of Journalism, and
in the Department of Computer
Science and Engineering atthe
University of Washington.
Peter von
Dadelszen, a
Professor in
the Depart-
■    mentof
k^M   Obstetrics and
Gynaecology and a world
authority on diagnosing and
treating pre-eclampsia,
received the 201 2 Knowledge
Translation Award from the
Canadian Institutes of Health
Research (CIHR).
Pre-eclampsia - the sudden
onset of high blood pressure
during pregnancy - is the
second-leading cause of
maternal death worldwide,
resulting in 76,000 women
dying each year, almost all of
them in lower- and middle-
ncome countries.
Dr. von Dadelszen's research,
spanning basic science, clinical
research and health services
evaluations, has included
publication of 130 articles
in high-impact journals.
He was the lead author of
guidelines issued bythe
Society of Obstetricians and
Gynaecologists of Canada for
diagnosis and management
of pre-elampsia and for use of
magnesium sulphate treatment
prior to labour to prevent
cerebral palsy. He also was a contributing author of the 2011
World Health Organization's
guidelines for the prevention
and treatment of preeclampsia and eclampsia.
Dr. von Dadelszen, the
Co-Director ofthe Reproduction
& Healthy Pregnancy research
cluster at the Child & Family
Research Institute, is leading
the development and testing
of a standardized surveillance
tool for detecting and
managing pre-eclampsia to
prevent maternal and newborn
complications.
Natalie
Strynadka,
Professor in the
Department of
Biochemistry &
Molecular Biology, is one of 13 researchers to
receive a Senior International
Research Scholar award from
the Howard Hughes Medical
Institute (HHMI).
Dr. Strynadka, the Canada
Research Chair in Antibiotic
Discovery and Medicine,
employs a multidisciplinary
structural biology approach to
study the molecular details and
function of membrane protein
assemblies, which play key
roles in antibiotic resistance
and bacterial pathogenicity.
Her goal is to use this
nformation to guide design of
novel antibiotics and vaccines
to treat bacterial infections.
Each HHMI senior international
research scholar will receive a
grant of $100,000 per year over
five years, and will present their
research at scientific meetings
held at HHMI.
Six faculty members have
been elected Fellows bythe
Canad ian Academy of Health
Sciences:
Jan Friedman,
Professor
in the
Department
of Medical
Genetics
and former Acting Associate
Dean, Research ofthe Child &
Family Research Institute, has
authored more than 200 peer-
reviewed papers and eight
books. His current research
focuses on the use of genomic
technologies to identify causes
of intellectual disability.
William Honer,
Professor and
Head ofthe
Department
of Psychiatry
and Director
ofthe Institute of Mental
Health, is the Jack Bell Chair
in Schizophrenia. His research
nterests include mechanisms
of illness in schizophrenia,
brain aging and complex
co-occurring illnesses such
as psychosis, addiction and
nfectious disease.
Andrei
Krassioukov,
Professor in
the Division of
Rehabilitation
Medicine, is
an internationally recognized
expert in autonomic dysreflexia
following spinal cord injury.
He is a physician in the Spinal
Cord Program at Vancouver
Coastal Health's G.F. Strong
Rehabilitation Centre and an
Associate Director of ICORD.
Christian Naus,
Professor in the
Department
of Cellular &
Physiological
Sciences and
Director of the Life Sciences
Institute, is a leading expert
on the role that intercellular
channels play in the developing
brain and in disease processes.
He is exploring the role gap
junctions play in neural
development and disease,
ncluding the consequences
of mutations on gap junction
structure and function.
^m^     I   Weihong Song,
Professor
in the
A >
Department
of Psychiatry
focuses on
the molecular and cellular
mechanism of Alzheimer's
disease. Dr. Song also has
facilitated Chinese-Canadian
research collaborations. In
2011, he received China's
highest honour for foreign
experts — the Friendship
Award.
Eric Yoshida,
Professor and
I    Head ofthe
Division of
Gastroenterology, is the Head
ofthe BC Hepatitis Program
— a partnership ofthe British
Columbia Centre for Disease
Control and the UBC Division of
Gastroenterology. He is also the
Past President ofthe Canadian
Association for the Study of
Liver and is a member ofthe
national governing board of
the Canadian Liver Foundation.
Dr. Yoshida is the past Medical
Director of the Liver Transplant
Program of BC Transplant.
James Hogg,
Professor
Emeritus
in the
Department
of Pathology 8
Laboratory Medicine, received
the 2013 Canada Gairdner
Wightman Award from the
Gairdner Foundation — the
country's premier honour for
leadership in medical science.
Dr. Hogg was selected for his
research leadership in Chronic
Obstructive Pulmonary Disease
(COPD). Dr. Hogg's research
focused on the mechanisms
and anatomical sites of
obstructive lung disease,
advancing knowledge of how
the lung works in health and
disease, including the pathophysiology of asthma and the
harmful effects of smoking and
pollution.
Created in 1959, the Gairdner Awards are Canada's only
globally-known international
biomedical prizes. Nineteen
ofthe last 26 Nobel Prizes in
medicine or physiology in the
past 10 years have gone to past
Gairdner recipients.
Jae Lee, Lab Manager at
ICORD, received the 201 2 UBC
President's Staff Award for
Emerging Leadership.
Lee started at ICORD as a
student technician. After
completing his master's
degree in 2010, he worked as
a research scientist before
becoming lab manager in June
2011. During his five years at
CORD, Lee has contributed
to numerous scientific
publications.
When a patient is enrolled in
the ICORD clinical trial, Lee
assists the nurses at any
time ofthe day, helping the
patient and their family to
understand ICORD's research
and mission. In addition to his
work in clinical research, Lee
mentors and coaches student
volunteers to help them
develop their skills. 24     UBC MEDICINE
ONE B.C. LEADER PAYS TRIBUTE TO ANOTHER
Brandt Louie, chair of British
Columbia's second largest
retailer, London Drugs, is the
first to support a professorship
to honour the legacy of Victor
Gomel, the pioneering head of
the Department of Obstetrics
and Gynaecology.
Louie's gift of $100,000 to the
L-R; Brandt Louie, Victor Gomel
Faculty of Medicine initiated fund-raising for the Dr. Victor Gomel
Professorship in Obstetrics and Gynaecology. Gifts totalling $3
million are needed to establish the endowed professorship.
Dr. Gomel's visionary leadership from 1978 to 1993 underpinned
the department's most notable accomplishments: launching
Canada's only PhD program in reproductive and developmental
sciences; establishing the InVitro Fertilization Program in
Vancouver, which resulted in Canada's first IVF baby in 1983;
and initiating the BC Women's Health Centre, the first tertiary
centre dedicated to women, newborns and their families in North
America.
"Exceptional training and innovation are critical to high-quality
obstetrical and gynaecological care," Louie says. "I encourage all
those who know Victor or care about women's health to contribute
to the professorship, too."
"The professorship will inspire new directions and new
collaborations to take full advantage of our province's wealth of
talent and expertise," says Geoffrey Cundiff, Professor and Head,
Department of Obstetrics and Gynaecology. "Our goal is to continue
making truly meaningful contributions to the lives of women and
families in B.C. and around the world."
7b support the Dr. Victor Gomel Professorship in Obstetrics and
Gynaecology, please contact Stephanie Huehn at 604-218-0275.
A FAMILY FOCUS ON AN OBSCURE DISORDER
Not long after Dan and Tina Priest's five-year-old son, Stephen,
was diagnosed with a rare hereditary bone disease known as
Morquio B, the Richmond family began fund-raising to support
UBC research into this neglected disease.
In 201 2, the Priests directed $51,589 in proceeds from their fund-
raising efforts to the Faculty of Medicine.
Stephen's physician and principal investigator, Sylvia Stockier,
Professor and Head ofthe Division of Biochemical Diseases in the
Department of Pediatrics, also successfully secured a $50,000
grant from the Priests through the MPS Society, which funds
research into mucopolysaccharidoses, a group of disorders caused
by malfunctioning or missing lysosomal enzymes.
"As a prerequisite to developing
a treatment for this ultra-
rare condition, we need to
understand the natural history
and pathophysiology," Dr.
Stockier says. "So our first goal
is to lay critical groundwork by
establishing an international
Morquio B disease patient
registry. The Priests are
driving our progress forward.
This comes atthe right time, because other researchers have
experimental data that support the feasibility of developing a
treatment."
7b support the Priest Family Fund for Morquio B, please contact
Leanne Denis at 604-822-2207.
L-R: Sylvia Stockier, Tina and
Dan Priest
A NEW TECHNOLOGY TO EXPLORE THE LOWER INTESTINE
When Joan Clarke needed single balloon enteroscopy to
diagnose the bleeding in her small bowel, she and her husband
Larry discovered that the procedure, which is the standard of
care across Canada, was not available in British Columbia.
In response to this need, the Vancouver couple donated
$75,000 to the Faculty of Medicine to purchase a single balloon
enteroscope to enhance both gastroenterology care and research
in their home province.
"The Clarkes' gift provides opportunities in treatment and clinical
research at UBC where none existed before," says Eric Yoshida,
Professor and Head, Division of Gastroenterology. "We expect
to do 20 single balloon procedures each year, which facilitates
therapeutic intervention and may reduce the need for surgery."
7b support gastroenterology research, please contact Stephanie
Huehn at 604-218-0275. W1L_IA3■/: -A. WEBBER
/ EDICAL STUD^xT ■ -
& ALUMNI CENTRE- DEVELOPING RESILIENCE
PRESIDENT'S REPORT
V1EDICAL ALUMNI ASSOCIATION
30ARD 2012-2013
President
Jack Burak, MD'76
President-Elect
Bob Cheyne, MD '77
Past-President
Marshall Dahl, MD '86
Treasurer
Harvey Lui, MD '86
Island Medical Representative
Ian Courtice, MD'84
Northern Medical Representative
Donald MacRitchie, MD'70
Southern Medical Representative
Tom Kinahan, MD'84
Michael Golbey, MD '80
Newsletter Editor
Beverley Tamboline, MD '60
Admissions Selection Committee
Jim Cupples, MD'81
Admissions Policy Committee
DavidW. Jones, MD'70
Directors
Bruce Fleming, MD'78
Ron Warneboldt, MD'75
Nick Carr, MD'83
Mark Schonfeld, MD'72
Hamed Umedaly, MD '86
Grover Wong, MD'92
Advisors
Arun Garg, MD'77
David Hardwick, MD '57
Charles Slonecker, DDS, PhD
Ex-Officio Members
Dean, Faculty of Medicine
Dr. Gavin Stuart (Hon.)
MUS Representative
Elisa Kharrazi, MD '15
Alumni Relations Director
Anne Campbell-Stone
Alumni Relations Officer
Kira Peterson
OBJECTIVES
To support the Faculty of Medicine and its
programs directly and through advocacy
with the public and government;
To ensure open communication among
alumni and between the alumni and the
Faculty of Medicine;
To encourage and support medical students
and residents and their activities;
To organize and foster academic and social
activities for the alumni
The Medical Alumni News is published
semi-annually and this edition was
produced by the UBC Faculty of Medicine
We welcome your suggestions, ideas and
opinions. Please send comments, articles
and letters to
Beverley Tamboline, MD '60
Alumni Affairs Faculty of Medicine
2750 Heather Street
Vancouver, BCV5Z3M2
Ph: 604 875 4111 ext. 67741
Fax: 604 875 5778
med.alumni@ubc.ca
Spring is a time of rebirth,
growth and renewal. The
days are lengthening, gardens
and lawns are revitalized,
natures energy is palpable and
optimism abounds.
For many in medicine, it is a
time of transition and change.
Final year medical students
and International Medical
Graduates anxiously await
the results of their Canadian
residency matches. The
outcomes for many will be
excitement as they pursue and
define their medical careers.
For some, the outcome will be
disappointment and a sense of
having fallen short of their goals.
Final year residents prepare
for exit examinations and look
forward to beginning their next
step as autonomous physicians
licensed for independent
medical practice. Some residents
anxiously face uncertainty about
work prospects in their chosen
disciplines of medical practice.
For some alumni, it is the time
of practice renewal and of
seemingly endless professional
membership dues, licensure
fees, and liability insurance
premiums.
These times of change are
stressful and anxiety provoking
for all of us, including our
families and loved ones. Most
of us remain committed to our
career paths and daily work
despite these challenges.
We remain optimistic,
enthusiastic and excited about
the important role we play for
our patients and their needed
medical care. For some of
us, the stress of our careers
and life's other challenges can
become overwhelming and
lead to a real sense of despair,
depression and heightened
anxiety. This may lead to the
loss of self-satisfaction and
disappointment in not meeting
the high standards we impose
on ourselves. We run the risk
of beating up on ourselves
- engaging in self-injury or risk-
taking behaviours. How can
we adapt constructively to life's
stressful situations and crises?
Resilience is often referred to
as hardiness or "psychological
muscle." Resilient people
recognize that perfection
is a fiction. They strive for
excellence through motivation
by creativity and enthusiasm.
Resilience to career stresses
starts with setting healthy
work boundaries and striving
for work/life balance. Sharing
on-call responsibilities, getting
over the guilt about not always
being there for your patients,
avoiding the temptation to
respond to every work email
on your personal time and
maintaining your emotional
integrity are some important
strategies. Taking care of one's
body, mind and soul, partaking
in hobbies, and taking the time
to be with family and friends
adds psychological muscle.
Resilience comes from
developing the perseverance
to work towards one's goals
and enhancing inner coping
strategies. Resilient people learn
to eliminate distortions from
their thinking and deal with
real problems. They enjoy the
present moment or activity by
paying attention, on purpose,
in the present moment without
judgment. Jon Kabaat-Zin
refers to this as the basis of
engaging fully in mindfulness-
based stress reduction. Finally
resilient people value their core
psychological driving needs
or priorities in life and use
them as guiding principles
and goals to bring meaning
to their work and to their life
in general. Their values will
motivate their involvement in
and commitment to work/life
balance. Ralph Waldo Emerson
describes the triumph ofthe
human spirit as the essence of
resilience:
"What lies behind you and what
lies in front of you pales in
comparison to what lies inside
ofyou"
Medical alumni colleagues are
a source of support for those
of us students, residents and
alumni who need assistance,
mentorship and friendship.
Collectively, we are familiar
with the UBC culture and
experience through our
education, familiar and similar
training, collegiality and
empathetic understanding of
both the highs and lows of our
professional journeys.
We welcome and encourage new
members with new ideas and a
renewed enthusiasm to join the
Medical Alumni Association
and lend their support.
Best wishes,
Jack Burak, MD'76
President
UBC Medical Alumni Association L - R: Class of 2016 students from the IMP huddle for a photo at their Student Welcome Reception; students from the SMP celebrating at their inaugural Student
Welcome Reception.
P AND SMP WELCOME THEIR CLASSES OF 2016
Island Medical Program
On January 19, the Victoria
Medical Society and Medical
Staff Association hosted the
9 th Annual Student Welcome
Dinner and Rural Medicine
Gala Fundraiser at the
Fairmont Empress Hotel in
Victoria.
The second-year class partnered
with the Victoria Medical
Society and Medical Staff
Association to organize the
dinner to welcome the Class
of 2016 to the Island Medical
Program and to assist with
raising funds for the second-
year rural medicine rotation
taking place this summer.
All the money was raised
through a student run silent
auction and ten dollars from
every ticket sold for this event
was donated to the rural
clerkship students who need
assistance with travel and living
expenses while working with
family doctors across B.C.
Many alumni and donors from
the Island medical community
attended this much anticipated
evening and were able to spend
the evening connecting with
the new cohort. From this class,
72 per cent had an existing
connection to Vancouver
Island, having attended a
Vancouver Island high school
or the University of Victoria.
Another important part of
the evening were the teaching
awards. Dr. Deke Botsford, Dr.
Chris Cameron, (MedRes'86),
and Dr. Ricardo Velazquez,
on behalf of the Orthopedics
clerkship, received the Island
Medical Program Excellence in
Clinical Teaching Award. Dr.
Ahmer Karimuddin received
the Vancouver Island Clerkship
Preceptor Teaching Excellence
Award and Dr. Ryan Gallagher
received the Resident Teaching
Excellence Award.
Thank you to the Victoria
Medical Society, BCMA,
MD Management, and the
Vancouver Island Health
Authority who sponsored this
event and helped make it such a
large success!
Southern Medical Program
One month after the IMP
Student Welcome Reception,
the Southern Medical Program
welcomed its Class of 2016 at
Volcanic Hills Winery with a
wine and cheese reception on
February 15.
This inaugural Student
Welcome Reception was
planned by UBC Faculty of
Medicine's Southern Medical
Program, which joined with
the Kelowna Medical Society
and second-year students to
officially welcome the second
cohort of 32 students to the
Southern Medical Program.
Unlike the Island Medical
Program, many of these new
medical students originate
from outside the Interior, so
this event created the perfect
opportunity for students
to connect with the local
medical community.
The evening started with
a tasting of some ofthe
Okanagan's finest wines
followed by a student-run
silent auction. All proceeds
from the silent auction go
to support the second-year
students who will be doing a
rural clerkship this summer.
Another highlight of the
evening was the teaching
awards. Dr. David Hawkins
received the Best Family
Practice Preceptor award, Dr.
Mark Hyslop received the Best
Clinical Skills Preceptor award
and Graeme McCauley, MD'74
and Ms. Rani Behl received the
award for Best PBL Tutors.
Thank you to Scotiabank,
Kelowna Medical Society, MD
Management, BCMA, and
CMA who sponsored this event.
Northern Medical Program
The premier event of the year,
the Dr. Bob Ewert Memorial
Lecture and Dinner, was held
on April 6 at the Prince George
Civic Centre. Presented by
the Northern Medical Society,
UNBC, Northern Health,
and the PG Community
Foundation, this event
honoured Dr. Bob Ewert who
was the first medical specialist in
Prince George.
Each year the Dr. Bob Ewert
Memorial Lecture raises funds
through donations for the
Northern Medical Programs
Trust, which supports the
training and retention of future
health care professionals in
the North.
During dinner, a keynote
presentation was made by Wade
Davis, ethnographer, writer,
photographer, film maker and
UNBC Honorary Degree
Recipient in 2010. This was
followed by the induction of
Robert McGuinness, MD'72
into the Northern Medical
Hall of Fame and mingling
of the northern medical
community with medical and
nursing students who have been
supported by the Northern
Medical Programs Trust. VERNON DOCTORS HOCKEY TOURNAMENT
HOCKEY NIGHT IN CANADA,
ID STYLE
Think back to your medical
student days—what sticks out
in your memory the most?
Whether it was skits nights,
study sessions, ski breaks,
the student play, spring gala,
the med ball, or my personal
favourite—weepers —we
balanced the rigors of studying
medicine with a fantastic,
built-in social life. We had the
"luxury" of spending nearly all
our time with our classmates
through a variety of activities
and opportunities. And those of
us in Vancouver were especially
lucky to have the MSAC as a
place to call our own. Now,
as practicing physicians, it is
all too rare for us to have the
opportunity to connect with
our colleagues —across all areas
of practice —to simply have fun.
This sense of community is
what the Vernon Doctors
Hockey Tournament is all
about. It was started by Dr.
Will Cawkell in 1982. The first
event was held in Lumby and
had four teams from Vernon,
Kelowna, Vancouver, and
Kamloops. The players were a
group of doctors who enjoyed
hockey, one another, and a cold
beer or two. What a great idea.
Like all great ideas, it caught
on. More than 350 physicians
and 24 teams from across
BC now participate in the
tournament, which is held
in Vernon (and one Lumby
arena) each year. The current
organizers are Dr. Will
Cawkell, Chris Cunningham,
MD '93, Gavin Smart, MD
'84, and Tammy Benischek.
Each participant gets to play
four games over the course of
the two days. They also get to
enjoy a beer garden, a Friday
evening symposium, and a
Saturday awards banquet with
a keynote speaker. Some of
the earlier events were known
to get quite rowdy. (Buns are
no longer provided at the
banquet!) Over the years,
the keynote speakers have
included the Honourable
John Crosbie, Guy LaFleur,
Dennis Hull, Gerry Cheevers,
Sheldon Kennedy, and Trevor
Linden. Funds raised from the
tournament are donated to
charities throughout BC.
This year the tournament was
held on March 1st and 2nd.
Teams of players came from
15 towns and cities across
British Columbia including
Kelowna, New Westminster,
Salmon Arm, Lumby, Prince
George, Vancouver, Kamloops,
Sechelt, Powell River, Nanaimo,
Oak Bay, Vernon, Victoria,
Surrey, and Penticton. Always
appreciated are the creative team
names such as the Vancouver
Flatliners and the Pedihatricks.
The medical symposium this
year featured Chris Andrews,
MD '93 who spoke about
"Vaccine preventable diseases
for the wanderer: travel tips"
and Dean Malish, MD '97
who described "Trauma Surgery
in Kandahar." If you would
like to find out more about
the tournament, please visit
www.vernondoctorshockey.ca.
To get a sense ofthe fun, look
for the video "Salmon Arm
Silverquacks Are Back" on
YouTube, created by the Salmon
Arm Silverquacks.
The Vernon Doctors Hockey
Tournament is an annual
highlight on the calendar
of many physicians. They
rearrange both work and family
schedules, organize car pools,
charter buses and start working
out and training early. All this
to carve out time to play hockey
and have fun with a bunch of
colleagues. That alone tells us
how important it is for all of
us to feel a part of this great
medical community.
The Vernon Doctors Hockey
Tournament is one ofthe largest
gatherings of physicians in B.C.
It encompasses virtually all areas
of practice —family physicians,
surgeons, internists, radiologists,
emergency physicians, and
psychiatrists, to name just a
few. Players are of all skill-
levels, a wide range of ages,
and both male and female.
Medical students and residents
are encouraged to join teams. It
is important to let them know
they are a part of our medical
community. It also doesn't
hurt that the up-and-coming
members of the profession tend
to be the more energetic players
and in better shape!
The tournament is held in early
March. We hope to see you
there in 2014.
Training starts early, and
recovery takes a long time!
Submitted by Chris Cunningham,
MD '93
OJNNfNMM
*  7  >fl  L-R; G. McCauleyMD'74;J. Carruthers, MD'71 and Dr. A. Carruthers
AWARDS, ACHIEVEMENTS, ACTIVITIES
Recipients ofthe Queen
Elizabeth II Diamond
Jubilee medal were Romayne
Gallagher, MD'84,
Dr. Larry Goldenberg
(Hon.), Victor Huckell,
MD'69, Dr. Christine
Loock (Hon.), Deborah
Money, MD'85, Garson
Romalis, MD'62, Mark
Schonfeld, MD'72, and
Ellen Wiebe, MD'75. This
prestigious award recognizes
Canadians who have made
a significant contribution
to their province, territory,
region or community, or
an achievement abroad that
brings credit to Canada.
Jean Carruthers,
MD'71 and Dr. Alastair
Carruthers, her husband,
wrote the third editions
of two of their text books
on neuromodulators
(Carruthers, A, Carruthers,
J. 2012. Botulinum Toxin:
Cosmetic and Medical
Uses. Philadelphia:
Elsevier) and soft tissue
augmentation (Carruthers,
J, Carruthers, A. 2012.
Sofi Tissue Augmentation.
Philadelphia: Elsevier).
At the Southern Medical
Program's Student Welcome
Reception, Graeme McCauley,
MD'74 was awarded with one
of the teaching awards for Best
PBL Tutor.
Adrian Ishkanian, MD'06,
has been appointed Assistant
Professor at the University of
Miami Sylvester Comprehensive
Cancer Clinic, Miami, Florida.
His work is both clinical and
research.
Linda Rabeneck, MD'74,
MPH'90 (Yale University),
was elected to Fellowship
in the Canadian Academy
of Health Sciences (CAHS)
in September 2012. Fellows
elected to the Academy are
well recognized by their peers
nationally and internationally
for their contributions to the
promotion of health science
and have demonstrated
leadership, creativity,
distinctive competencies and
a commitment to advance
academic health science.
Dr. Rabeneck, a Professor
of Medicine and Professor,
Dalla Lana School of Public
Health at the University of
Toronto, currently serves as
Vice-President, Prevention
and Cancer Control at Cancer
Care Ontario, the province's
cancer agency. She has played a
leadership role in implementing
organized colorectal cancer
screening in Ontario, the first
province to launch a province-
wide, publicly funded colorectal
cancer screening program.
Top L-R: M. Schonfeld, MD'72; R. Gallagher, MD'84
Middle: D. Money, MD'85
Bottom L-R:G. Romalis, MD'62; L Rabeneck, MD'74 WILLIAM- A, WEBBER
■ "^£^CAL. STUIHMT
u AUUMNI
R: Shingles which were presented to the
Class of 2012 during the Hooding Ceremony;
the entrance to the William A. Webber Medical
Student & Alumni Centre
UBC MEDICAL ALUMNI ASSOCIATION MEMBERSHIP
The UBC Medical Alumni
Association would like to
thank everyone who became a
member in 2012.
As a member ofthe UBC
Medical Alumni Association,
you have access to invaluable
opportunities for connecting
with medical alumni across
B.C., throughout Canada, and
around the world, as well as
supporting the next generation
of medical students.
The UBC Faculty of Medicine
-with over 5,000 MD alumni
-is active at university and
clinical campuses throughout
B.C., including the Vancouver
Fraser Medical Program, the
Northern Medical Program in
Prince George, the Southern
Medical Program in Kelowna
and the Island Medical Program
on Vancouver Island. In addition, students and alumni are
connected through state-of-the-
art videoconferencing, which
facilitates a wide range of professional, social and recreational
connections for students and
alumni province-wide.
Your membership and
additional donations support
the many vital initiatives with
which the Medical Alumni
Association is involved
throughout the year.
Please sign up for membership
today and continue to keep
your membership current each
year to be part of this influential
network of peers. Your
additional donation will support
our project—the development
of social and recreational centres
for students and alumni at each
of our program locations.
Your membership fee and
additional donations support
social and recreational events
and activities for medical
students on university and
clinical campuses across
B.C., including the ongoing
operations of the William A.
Webber Medical Student &
Alumni Centre (MSAC) in
Vancouver, a unique social and
recreational centre for medical
students alumni, as well as the
development of new social
and recreational centres for
medical students and alumni
in Kelowna, Victoria and
Prince George, state-of-the-art
videoconferencing technology
to connect students and alumni
across B.C., support with
the yearbook and the annual
hooding ceremony, a gift of
a "doctor's shingle" for each
member ofthe graduating MD
class, and the MAA's Annual
Recognition Awards program,
including the Wallace Wilson
Leadership Award and our
Honorary Medical Alumni
Awards.
Please complete the attached
2012 membership subscription
form or go to http://
s tartanevolution. ub c. ca/maa
and help us to continue to build
our community of medical
students and alumni.
UBC Medical Alumni Association 2013 Membership Subscription
Name.
Address.
City	
Province/State.
Postal Code	
Country	
Field of Practice
Email 	
Phone 	
Please include in my subscription:
□ Regular membershipfee of $65       or      □ Medical resident atthe reduced fee of $25
□ Donation amount*:      Q $435       □ $235       □ $135      □ Other $ 	
Total amount: $     *Your donation is tax deductible.
If you require a MSAC access card, please contact med.alumni@ubc.ca or 604.875.4111 ext. 67741
Preferred payment:
D I have enclosed a cheque payable to the University of British Columbia.
D I am using my credit card:    DVisa       D MasterCard       DArnex
A
Card Number
Signature
zxpirytmm/yy) Top: E. Kharazi, MD'15 (2nd from
ieft) at the Celebration of Medicine
and the Arts Reception
US REPORT
2013 has proven to be an
already productive year for the
UBC Medical Undergraduate
Society and our student body.
In early February, five UBC
medical students travelled
to Ottawa to participate in
the Canadian Federation of
Medical Students' (CFMS)
Federal Lobby Day. We met
with Members of Parliament
to discuss the inception of a
pan-Canadian health human
resource plan to provide needs-
based projections of physician
supply and demand. This
initiative would assist medical
students in selecting specialties
MSAC REPORT
MSAC Gym: Good Health
from Exercise at MSAC
Medical school can be a
marathon. While balancing
home life and school through
two pre-clinical years, two
clinical clerkship years, and
from two to infinity years of
postgraduate study, it's easy for
students to neglect their own
health while focusing on others.
Fortunately, the MSAC gym
provides an outlet for the
ones who want to answer
the question, "Bro, do you
even lift?" with a masculine,
affirmative grunt.
that would best meet the needs
of our patients. We received
encouraging responses from
government officials and are
currently in discussions with the
responsible minister.
On February 19 th the MUS
hosted the ninth annual
UBC Medicine Research
Forum alongside the UBC
Medical Journal (UBCMJ)
and the Faculty of Medicine.
Over 50 abstracts were
presented by budding
researchers at this event. We
also launched the latest issue
ofthe UBCMJ focusing on
"Clinical Genomics."
'MSAC is the William A
Webber Medical Student and
Alumni Centre, a social and
recreational facility for the use
of UBC's Faculty of Medicine
community. In a small building
huddled across from the VGH
complex, medical student
volunteers created and maintain
the free weight and cardio gym.
Third-year medical student
Rebecca Hartley emphasizes
the importance of matching
crazy hours of call schedules
and exam cramming: "After
sitting all day, it's really nice to
go to MSAC gym and work off
stress. The 24 hour availability
UBC medical students will
continue to have an action-
packed year. On March 9,
our students demonstrated
their extraordinary artistic
abilities at the annual Med
Gala, a talent show featuring
some our best musicians,
dancers and performers.
As well, in September we will
be proud to host the CFMS
Annual General Meeting in
Vancouver for the first time in
over 30 years. We thank the
Medical Alumni Association for
their generous sponsorship of
this meeting.
We look forward to hosting
our colleagues from across
is convenient for our hectic
schedules."
On an given evening, anywhere
from 20-30 medical students
and residents drop in and take
advantage ofthe facilities,
meeting up with familiar faces
Canada, and to a busy and
exciting rest of the year.
At MUS we are focused
on providing students with
an unrivaled educational
experience. This is only
possible with the continual
support and collaboration
of UBC medical alumni and
community members. If you
have any questions about the
MUS or ideas on how we
can collaborate, please don't
hesitate to contact me.
Sincerely,
Elisa Kharazi, MD'15
President, Medical
Undergraduate Society
ekharazi@alumni. ub c. ca
from other medical programs
to sweat out the day and meet
friends and colleagues from the
medical community.
Kevin Wade, Year III, MD'14,
MUS Sports Director
Students working out in the MSAC gym. STUDENT EVENT HIGHLIGHTS
L-R: Cast of "Picasso at the Lapin Agile" on
opening night; D. Heffner, MD'13 performing
at the Celebration of Medicine and the Arts
reception prior to the Spring Gala
2nd Year Play
Picasso at the Lapin Agile
The Med Play is a spring
tradition and celebrated its
11 th Anniversary with this
year's production of 'Picasso
at the Lapin Agile," which
was presented from February
20 to March 1.
Written by Steve Martin, the
play is set in 1904 in a bar
called Au Lapin Agile. It is an
actual bar that exists in the
Montmartre district of Paris.
It was originally owned by a
man named Freddy, and artists,
including Pablo Picasso, were
regulars. The play is Steve
Martin's imagined encounter
between Albert Einstein and
Picasso when Einstein visits the
bar one evening. It's unlikely
Einstein ever went to Au Lapin
Agile, but both Picasso and
Einstein were on the cusp
of greatness in 1904 — one
year later "the Special Theory
of Relativity" was published
and Picasso entered his "rose
period." "Picasso at the Lapin
Agile" humourously explores
what would happen if these
geniuses had met in a bar (and
met a time-travelling star from
the 20th century while there).
In the cast were nine students
from medicine and dentistry
and five student producers.
In addition, five students helped
build the stage, eight helped by
donating baked goods for the
concession, and 12 volunteered
to help with ushering/being a
cashier for the performances.
This really was a student-driven
performance!
2013 Medical Ball
The annual Medical Ball is
the greatly anticipated formal
evening of the year. This year's
Med Ball theme was James
Bond and it brought together
students from all years to join in
on a night that featured dinner,
dancing, teaching awards, and
entertainment.
Three hundred and fifty guests
attended Med Ball which was
held Saturday, March 23, at the
Four Seasons Hotel Vancouver.
Other entertainment included
after-dinner "gambling"... with
fake money of course, and the
crowd favourite photo booth.
This year the MUS presented
Jason Ford, MD'96 with
not only the Class of 2015
Excellence in Teaching award
but also the Dr. William A.
Webber award. The Class of
2014 recognized Jason Hitkari,
MD'OO and the Class of 2013
recognized Dr. Jagdeep Ubhi as
the recipients of the other two
Excellence in Teaching Awards.
A short recognition of Dr.
Sharon Salloum was featured
as she will be retiring at the
end of the year.
The event was emceed by the
stars of the Med Play, Amar
Cheema and Charlie Walsh.
Thank you to Haslett Insurance
and the CMA who sponsored
this event.
Ben Millar, MD'15 Year II VP
Social
Spring Gala 2013
The UBC Medicine and
Dentistry Classes held their
19th annual Spring Gala on
March 9th. Inspired by former
Associate Dean of Student
Affairs, Dr. Andrew Seal, whose
interest in colorectal surgery was
tempered by his passion for the
arts, this event gives medical
students an opportunity to
showcase their diverse range of
talents. This year's gala featured
a number of the traditional
group acts, such as Karotid
Chop, Bhangra Without
Borders, the Hardwick Strings,
and the Black and Blues band,
in addition to some incredible
individual and small group
performances from students
in all years of the program.
Proceeds from the gala are
typically donated to a local non
profit organization voted on
by students. This year's chosen
organization, the Kelty Patrick
Dennehy Foundation, focuses
on preventing depression-
related suicide in young people.
The Spring Gala also serves as a
vehicle for alumni to reconnect
with their alma mater. Before
the show on March 9th, the
Faculty of Medicine held a
special reception where alumni
and donors could regale
themselves with memories from
their own days in the program.
As well, during intermission the
atrium was filled with nostalgia,
as groups of current students
and alumni shared their stories
and experiences. So, please,
mark March 2014 in your
calendar for the 20th annual
Spring Gala and come and see
what talent the next generation
of UBC medical students has in
store for us all!
Chris Nixon-Giles, MD'13
Spring Gala MC Annual General Meeting
and Awards Reception
Please join usforthe announcement and celebration of our 2013 Award recipients
on Thursday, May 9,2013 at 6:30pm at the Medical Student Alumni Centre!
Wallace Wilson Leadership Award Honorary Medical Alumni Award
Victor McPherson, MD'54 Dr.Shafique Pirani
Dr.AubreyTingle
Silver Anniversary Award
TBA
mation, please contact
med.alumni@ubc.ca <
Upcoming Events
MAA Annual
General Meeting
May 9, 2013
Vancouver, BC
Hooding Ceremony
May 21, 2013
Vancouver, BC
Student Graduation
Ceremony
May 25, 2013
Vancouver, BC
UBC Alumni Weekend
May 25, 2013
Vancouver, BC
UBC Medical Alumni
& Friends Golf Tournament
June 20,2013
Vancouver, BC
Event Highlights from 2012-2013
UBC Faculty of Medicine
SMP Student Welcome
Matters of Life and Death
Student Welcome Reception
Reception
A panel discussion about
All health disciplines
February 15, 2013
critical illness and end-of-life
October 12, 2012
Kelowna, BC
considerations.
Vancouver, BC
Panelists: Romayne
Vernon Doctors Hockey
Gallagher, MD'84; Erik
UBC Midwifery Program's
Tournament
Vu,MD'03;Dr.AnitaHo;
10th Anniversary
March 1-2, 2013
Jonathan Meadows, LLB '96
November 8, 2012
Vernon, BC
Vancouver, BC
Victoria, BC
November 10, 2012
Spring Gala & Celebration
Dr. Bob Ewert Memorial
Vancouver, BC
of Medicine and the Arts
Lecture
Reception
April 6, 2013
Victoria Medical Society
March 9, 2013
Prince George, BC
Student Welcome Dinner
Vancouver, BC
January 19, 2013
For more information
Victoria  RC
regarding past or upcoming
V  I \j LU I   Id,   UO
9th Annual Run for Rural
events, please call
Medicine
604-875-4111 X67741.
March 23, 2013
Vancouver, BC SAVE  THE  DATE
U8C MEOICAt ALUMNI & fRlENDS GOIF TOURNAMENT
THURSDAY  •   JUNE  20 •  2013
UNIVERSITY GOLF COURSE
518,5 UNIVERSITY BLVD UBC FACULTY OF MEDICINE
FACULTY OF MEDICINE
NORTHERN HEALTH AUTHORITY
fo        O
9 University Academic Campus
■^ Clinical Academic Campus
9 Affiliated Regional Centre
O Community Education Facility
University Academic Campuses
Jniversityof British Columbia (UBC) Vancouver campus
Jniversityof British Columbia (UBC) Okanagan campus
Jniversityof Northern British Columbia (UNBC) in Prince George
Jniversityof Victoria (UVic) in Victoria
•  Affiliated Regional Centres
Abbotsford Regional/Chilliwack General Hospitals
=t. St. John General/Dawson Creek Hospitals
Jons Gate Hospital
Mills Memorial Hospital
Janaimo Regional General Hospital
Richmond Hospital
Royal Inland Hospital
St. Joseph's GeneraL/Campbell River General
/Cowichan District Hospitals
Vernon Jubilee/Penticton Regional Hospitals
~K Clinical Academic Campuses
3C Cancer Agency
3C Children's Hospital
3CWomen's Hospitaland Health Centre
Kelowna General Hospital
Royal Columbian Hospital
Royal Jubilee Hospital
St. Paul's Hospital
Surrey Memorial Hospital
Vancouver General Hospital
Victoria General Hospital
Jniversity Hospital of Northern BC
O Community Education Facilities,
Rural and Remote Distributed Sites
Serving medicalstudents and residents,
student audiologists, speech language pathologists,
occupational therapists, physical therapists
and/or midwives in the community
DUBLICATIONS MAIL AGREEMENT NO. 41 02050S
RETURN UNDELIVERABLE CANADIAN ADDRESSES TO:
Faculty of Medicine
The University of British Columbia
317-2194 Health Sciences Mall
Vancouver, BC
Canada V6T1Z3
T: 604 822 242'
=: 604 822 606'
www.med.ubc.ca
FACULTY OF MEDICINE

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