Reflections

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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

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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

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Hissan Butt is a medical student at Queen’s University in Kingston, Ontario

 

I recently learned that two Canadian medical students died in the past three weeks. Little is known about the circumstances surrounding these deaths.

However, this has not stopped worried Canadian medical students from speculating about the causes of death. The speculation arises not because of a desire to gossip. Rather, I think, it stems partly from a lack of information and partly because of fear. At the time of writing, most believe that the students died by suicide. One university has acknowledged the death of one of the students, although the cause is not identified.

The silence is justified - we are told through unofficial sources – by a request from the families to respect their right to privacy. We are also told that talk might spark copying. Indeed, any decent person should want to respect the wishes of the bereaved families, to help them grieve and lighten their burden in this difficult time. There is no need for naming, but there is a need to talk. ...continue reading

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Meagan Mahoney is a pediatric intensivist at Alberta Children’s Hospital in Calgary

Jennifer Woolfsmith is Mackenzy’s mom

Matthew Weiss is a pediatric intensivist at the Centre Mère-Enfant Soleil du CHU de Québec and medical director of organ donation at Transplant Québec

 

 

Organ donation is a gift. Not just for those who receive, but often for the families of those who give.

When 22-month-old Mackenzy Woolfsmith died suddenly and tragically in 2012, her organs saved the lives of four people. For her parents, this decision has made a lasting, positive impact on their lives, one of the few positive aspects they were able to salvage from this traumatic loss. The story of Mackenzy’s parents’ experience of organ donation as a gift received, as an integral part of end-of-life care and bereavement, is, we believe, a story that is not told often enough. ...continue reading

Mandi Irwin is a family physician at the Nova Scotia Health Authority's Newcomer Health Clinic, in Halifax, NS

Elizabeth Munn is a medical student at Dalhousie University

 

Hamid Abdihalim is a medical student at Dalhousie University

Matthew Ta is a medical student at Dalhousie University

 

 

Human displacement as a consequence of war, natural disaster, civil conflict or political instability is not a new problem. The ongoing war in Syria has brought this issue into mainstream view recently. This and other protracted and escalating conflicts have resulted in the displacement of over 22.5 million refugees globally, as estimated by the United Nations High Commissioner for Refugees. In 2016 alone, almost 190,000 refugees were resettled in new countries around the world. This includes resettlement in Canada, which has welcomed over 25,000 refugees from Syria [1].

We often fail to appreciate that once refugees arrive in their countries of resettlement, they face substantial challenges ...continue reading

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Daniel Miller is a Physiatrist (Physical Medicine and Rehabilitation) in Lethbridge, Alberta

 

Income splitting has come under attack by the current Federal Liberal Government as an unfair tax advantage for certain individuals and several proposals put forward to eliminate certain “tax loop holes” may have a further reaching impact that revenue generation and impact our charter rights. We shouldn’t be discussing tax loop holes, but rather the effects of income splitting being a charter right for all Canadians. While I use the term marriage specifically, I would also include civil union and common-law partners to whom the same legal rights apply.

I recently met with my accountant to review the financial details of my medical practice. He told me and my wife that we would no longer be able to income split due to the proposed changes in Federal taxation legislation. ...continue reading

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Max Deschner is a medical student at the University of Ottawa

Maaike de Vries is an epidemiologist & PhD candidate at the University of Toronto

Jonathan Gravel is an epidemiologist & resident physician at the University of Toronto

 

 

Pain is one of the most common reasons patients present to emergency departments and primary care clinics, as well as a common complaint among patients treated by subspecialty services. Physicians will agree that treating pain is vital. Yet despite grossly inadequate training in pain management – physicians are expected to offer multimodal pain management (including pharmacological, non-pharmacological and behavioural therapies). All too often, patients with acute or chronic pain also do not have a complete understanding of what options should be available to them and how to access them. Needless to say, an informed and bidirectional discussion between providers and patients about pain management before an opioid prescription is written is an all too rare occurrence. ...continue reading

Justin Lam graduated from University of Toronto Medical School in 2017 and is now a first year resident in Paediatrics at UofT and SickKids

 

Denis Daneman is Chair Emeritus, UofT Dept of Paediatrics, and Paediatrician-in-Chief Emeritus, SickKids

 

The Mentee: JL

I sat in front of my laptop, staring at an email draft to a potential mentor. I knew it was pointless trying to perfect it, but I felt I needed to read it just one more time. He was, after all, a legend in my medical world, a well-respected clinician and expert in the field, with a prolific academic career and an illustrious research career. Also, I had only interacted with him a handful of times before. I was reaching out to him because of what I perceived to be his ability to balance his career with a family. How had he done it? I hit send. His reply came not 10 minutes later. Our first meeting was set.

Before I knew it, we were meeting for the third time. It was during this meeting that I was given an article written by a psychiatrist about how he had chosen not only his specialty, but also between a “quiet life” and a “calling” , a process that I myself was going through at the time and had begun to explore with the help of this mentor. ...continue reading

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Ally Fleming is a writer and publicist at Anstruther Press

 

Illness doesn’t end when you leave the doctor’s office. Affliction is carried, and pain is, as Shane Neilson writes, “a concerto in your back pocket.” As a writer with bipolar disorder and chronic pain, I’ve often felt utterly lost, blinded by what Rita Charon calls the “glare of sickness” . For many, the fundamental question of medicine is not how to be fixed (for it’s often not possible), but how to live one’s life, broken. Physician and pain researcher Shane Neilson’s trilogy of poetry collections from Porcupine’s Quill leads by example.

“Practitioners, be they health care professionals to begin with or not, must be prepared to offer the self as a therapeutic instrument," (p. 215) writes Charon in Narrative Medicine: Honoring the Stories of Illness. Neilson, with one foot perpetually planted in medical practice and the other in love, unflinchingly offers himself to his readers ...continue reading

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Wendell Block is a family physician at the East End Community Health Centre and the Canadian Centre for Victims of Torture

 

In the thirty-odd years I have worked with torture survivors, I have heard countless versions of the following story. When Azad* was a 22- year-old university student in his home country, he participated in a public demonstration, criticizing the government’s financial cuts to social programs important to his minority group. He and many other demonstrators were apprehended and brought to a crowded holding centre. They slept on the floor, had limited access to a dirty toilet, and were given a cup of water with a small amount of non-nutritious food twice a day. Azad was taken for interrogation on three occasions. He was accused of having links to terrorist organizations outside the country, and of spreading seditious ideas (his interrogators had found political leaflets in his backpack). They demanded the names of organizers. While being questioned he was struck repeatedly on his back and thighs with police batons, and on the third occasion they beat the soles of his feet. Afterwards he could not ...continue reading