Reflections

Mark Soth is a mid-career academic intensivist in Ontario, Canada. He blogs as the Loonie Doctor about physicians' personal finance

 

We really have come a long way as a society in that "the talk" is not so much of a big thing anymore. We speak more openly about sex - the benefits, the pitfalls, and the repercussions both within our families and in our public institutions. It is no longer a major taboo. That was not always the case.

Historically, the taboo of sex has contributed to much misery. For example, when syphilis ran rampant around the world in the 16th century, many were denied care because it was considered “the wages of sin”. Of course, they treated syphilis with mercury back then, so that may have been worse. The advent of penicillin as an effective cure for syphilis in the 1940s was revolutionary, but it still did not eradicate the disease. With penicillin, education, and condoms - syphilis is much less common now, except on internal medicine exams.

Did all that talk about sex make you uncomfortable? Probably not. In fact, some medical nerds are probably chomping at the bit to correct me on some fact about syphilis.

"Let's talk about money." ...continue reading

Natasha Sarah Crowcroft is Chief of Applied Immunization Research at Public Health Ontario and a Professor at the University of Toronto in Laboratory Medicine and Pathobiology and the Dalla Lana School of Public Health. Her work aims to maximize the public health benefits of immunization.

 

It is good to celebrate anniversaries of major achievements in public health. The bicentenary anniversary of the publication of Dr. Edward Jenner’s paper on vaccination against smallpox, published in 1796, was celebrated on the cover of the 1996 edition of the United Kingdom’s (UK)’s immunization guide, marking one of the greatest achievements of humankind. Recently however we reached the anniversary of a publication that we might all rather forget.  Twenty years ago in February 1998, two years after the celebration of Jenner’s legacy, The Lancet medical journal published a paper describing a small case series of “ileal-lymphoid-nodular hyperplasia, non-specific colitis and pervasive developmental disorder in children”. The story has been described ...continue reading

Magbule Doko is a family physician in Windsor, Ontario, and an adjunct professor at The University of Western Ontario

 

 

Our decision, firm and dedicated
To become doctors: a noble profession
Long years of heads in our books
Clinical years of emotional turmoil
Oh yes you did not know
Their stories touched us, imprinted on our minds
We wept ...continue reading

1 Comment

Howard Abrams is the Director of Openlab, a design and innovation shop located at the University Health Network (UHN) in Toronto

 

Andre Picard recently proposed in the Globe and Mail: “if we want a healthier Canada, we should spend less on healthcare.” This may, at first, seem counterintuitive, but it has been long recognized that the social determinants of health are at least as, if not more, important in the health of a population. This is where food intersects with public health in a pivotal way. If we look at the evidence, we know that food insecurity and poor housing are two major risk factors for chronic disease and adverse health outcomes. Patients we serve don’t show up out of thin air, but come out of a community environment rich with factors that impact their health ...continue reading

Paul G. Thomas is Professor Emeritus of Political Studies at the University of Manitoba. From 2004 to 2007 he served as the founding board chair for the Manitoba Institute for Patient Safety.

 

My introduction to the complex and emotional world of adverse events in healthcare occurred in 2001 when I chaired a committee to review an inquest report into the tragic deaths of twelve infants in a paediatric surgery program in Manitoba. Justice Murray Sinclair who conducted the inquest had concluded that at least five of the deaths were preventable.

Back then there was no apology law in Manitoba.  Neither the Sinclair report (2000) nor the Thomas report (2001) recommended the adoption of such a law.   ...continue reading

1 Comment

Lawrence Loh is an Adjunct Professor at the Dalla Lana School of Public Health at the University of Toronto

 

I took up run-commuting following the birth of my first child because leisure time physical activity just wasn’t going to happen. My office had a shower, and what better way to counter the drudgery of the commute? I soon discovered mental calisthenics were also part of the running deal—not only in planning logistics, like ensuring you have enough toiletries, underwear, and the right accessories at the office—but also in the opportunity to sharpen one’s sense of observation.

The routine of run commuting leads one to notice patterns over time. If you leave at the same time most days, ...continue reading

Adam Kassam  is the chief resident in the Department of Physical Medicine & Rehabilitation at Western University

Jeremy Wasserlauf is a fellow in cardiovascular disease at Northwestern University Feinberg School of Medicine

 

The meteoric rise of bitcoin has fueled worldwide interest in cryptocurrencies and, more broadly, blockchain technology. The once obscure brainchild of Satoshi Nakamoto has evolved into a speculator’s paradise, rivaling the dot-com bubble of the early 2000s. While bitcoin’s future as a digital currency is a topic of debate, its underlying blockchain software has become the foundation for a technological revolution that began in finance, but is quickly transforming other industries. The application of blockchain to the world of healthcare may prove to be its most humanitarian of functions.

Acclaimed as one of the biggest innovations since the internet itself, blockchain eliminates trusted third parties such as banks from online transactions and replaces them with a decentralized database, or a ledger, of transactions. The ledger is stored across a network of computers that is visible to everybody, and a combination of cryptographic keys is used to create a secure reference of identity. ...continue reading

1 Comment

Sharon Yeung is a MD/MSc student at Queen’s University

 

I’ll be the first to admit: I’ve never been one for politics.

The garish lawn signs of electoral campaigns, the predatory advertisements and the shiny, charismatic politicians, bred in me a deep political apathy at an early age. It was an apathy fueled by a lack of understanding of how these matters were relevant to my daily life – and for the most part, my political apathy was left unchallenged.

I suspect my experiences are not unlike those of my peers in my generation. After all, weren’t we all once taught that politics is a sacred taboo? The kind you should never talk about at dinner, second only to religion. As it turns out, it’s also the kind you don’t talk about in polished Medical School Classrooms.

The apolitical culture of medical school is, however, not inconsequential. ...continue reading

3 Comments

Sarah Tulk is an Ontario physician who recently finished her residency training in family medicine at McMaster University

 

“If only he had chosen a higher floor, we wouldn’t have had to come here!”

These were the words that came out of my preceptor’s mouth. I was a wide-eyed medical student, shadowing in orthopedic surgery. The patient was an older man who had sustained multiple fractures after attempting to end his life by jumping from an apartment building balcony. The trauma ward was full, so he was, inconveniently, located on a distant ward which meant his poor choice of departure level was now encroaching on our operating room time. In medical school, I learned that mental illness was shameful before I learned how to use a stethoscope. ...continue reading

2 Comments

Mehdi Aloosh is a Public Health and Preventive Medicine resident (R1) at McMaster University and a graduate of medicine from Tehran University and master’s in surgical education from McGill University

 

Cal Robinson is a pediatric resident (R1) at McMaster University and completed medical school in the UK

 

International Medical Graduates (IMGs) that match to residency positions in Ontario are required to participate in the Pre-Residency Program (PRP) in order to begin their residency.  We participated in the 2017 PRP program as trainees and benefited from the learning opportunities specific to practicing medicine in Canada that the program provided. However, the PRP program structure does not follow the fundamental principles of Competency-Based Medical Education (CBME). PRP re-design, incorporating a CBME model of outcome-based assessment with identification of residents requiring additional support would optimize ...continue reading