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Message from the Division Director
Dear Colleagues,
Thanks to all who are continuing to work on the front lines of COVID and other patient care. As cases increase across the GTA, this is putting a disproportionate strain on some hospitals within the system. In order to address this and to ensure safe and equitable patient care, Ontario Health has created a GTA Hospital Incident Management System to manage hospital capacity across the region. At times, this may necessitate the transfer of patients between hospitals.The GIM division heads across the GTA are meeting regularly to guide this process so it can be as safe and effective as possible. If you have suggestions, please speak to your division head or to me. I will share updates with the division as they are available.
In the meantime, thanks to the chief medical residents for coordinating an outstanding virtual resident retreat last weekend, congratulations to our award recipients, and welcome to our new faculty.
Sincerely,
Moira
Dr. Moira Kapral, Director, Division of General Internal Medicine, University of Toronto
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Stephen Hwang receives President’s Impact Award
Stephen Hwang has been awarded the President's Impact Award from the University of Toronto, in recognition of his work to improve the health of people experiencing homelessness and to make health equity and social justice central to medical practice.
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Zac Feilchenfeld receives Inpatient Education Award
Zac Feilchenfeld has been awarded the Inpatient Education Teaching Award from the Department of Medicine, Sunnybrook Health Sciences Centre.
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Robert Fowler receives Senior Researcher Award
Robert Fowler has been awarded the Senior Researcher Award from the Department of Medicine at Sunnybrook Health Sciences Centre.
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Ariel Lefkowitz receives Part-Time Teacher Award
Ariel Lefkowitz has been awarded the Part-Time Teacher Award from the Department of Medicine at Sunnybrook Health Sciences Centre.
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Steve Shadowitz receives Dr. Peter Webster Award
Steve Shadowitz has been awarded the Dr. Peter Webster Award for Excellence in Teaching and Patient Care from the Department of Medicine at Sunnybrook Health Sciences Centre.
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Gillian Spiegle
Gillian Spiegle joins the Division of GIM as an Assistant Professor and Clinician-Teacher based at Mount Sinai Hospital. She holds a Bachelor of Health Sciences from McMaster University and completed her MD, core internal medicine training and GIM subspecialty training at the University of Toronto. She also has her Masters in Community Health in Health Practitioner Teacher Education from the University of Toronto. Her clinical and academic interests include teaching residents to teach, trainee wellness, procedures and medical education. She is the Simulation Lead for the Core Internal Medicine program and is looking forward to soon starting as the Mount Sinai Clerkship Co-Site Director and the Education Lead of the Mount Sinai Ambulatory Clinic.
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Eric Kaplovitch
Eric is thrilled to be joining the division as a Clinician in Quality & Innovation at Sinai Health System and the University Health Network. Eric completed his Internal Medicine and General Internal Medicine fellowship at the University of Toronto, and completed dedicated Thrombosis and Vascular Medicine training at McMaster University and the University of Toronto. His academic interests include the care of patients with arterial or venous thrombosis, preventing vascular events in pregnancy, as well as the teaching of Internal Medicine, Vascular Medicine and Thrombosis to trainees and front-line clinicians. Fun fact: Eric coached tennis for over a decade, has recently taken up cycling, and is a lifelong jays fan!
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Meetings and Other Announcements
University of Toronto GIM Citywide Rounds
The next GIM Citywide Rounds will be held on Friday, November 27 from 12-1 PM via Zoom. Dr. Alexandra Saltman will provide a primer on using biologic therapies and Dr. Ayelet Kuper will lead a session on allyship and anti-racist practice. If you would like to attend but have not received the calendar invitation with Zoom details, please email joe.graves@uhn.ca.
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Acute Care Update: Registration Open
St. Joseph's Health Centre is pleased to announce the return of Acute Care Update 2020. The in-person annual conference has been cancelled. The 2020/21 version of Acute Care Update will be presented as four virtual programs hosted on ZOOM.
The 2020 Acute Care Update will be free of charge. To receive the ZOOM videoconference link, users must register for the program in advance. For more information and to registration see here.
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Canadian Journal of General Internal Medicine (CJGIM)
Consider submitting original research (including systematic reviews) to the CJGIM. They offer a rapid turnaround in the context of a rigorous peer-review process and easy-to-navigate manuscript submission portal. The CJGIM would be an ideal destination for preliminary research (e.g. pilot study data) or study design articles, where timely publication prior to a grant competition or performance review, may be important.
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Clinician Teacher/Clinician in Quality and Innovation, UHN/MSH
The Department of Medicine, Temerty Faculty of Medicine at the University of Toronto and the Divisions of General Internal Medicine and Geriatrics of the University Health Network (UHN) and Sinai Health System (SHS) are seeking to recruit 2 to 3 academic general internists to be based at UHN - Toronto Western Hospital and Sinai Health System. The successful candidate(s) should have an interest in inpatient and outpatient general internal medicine. Candidates must currently hold or be eligible for a University of Toronto full-time clinical academic appointment at the rank of Lecturer or Assistant Professor and should fulfill the academic position description of a Clinician Teacher or Clinician in Quality and Innovation. Read more….
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Clinician Scientist, UHN/MSH
The Department of Medicine, Temerty Faculty of Medicine at the University of Toronto, Sinai Health System and University Health Network are seeking to recruit an academic General Internist to join the Divisions of General Internal Medicine and Geriatrics. The successful candidate should be eligible for a full-time clinical academic appointment at the rank of Lecturer or Assistant Professor with the position description of Clinician Scientist. Read more....
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Trainee Awards
Royal College/JGME Top Resident Research Papers: Dr. Maxime Billick
2020 Canadian Society of Internal Medicine (CSIM) Education and Research Fund Award: Dr. Arnav Agarwal
The Philip Berger Advocacy Award: Dr. Arnav Agarwal
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Journal Articles
Divisional members have published the following journal articles since the last issue of the GIM newsletter:
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1. Longitudinal interrelationships of mental health discrimination and stigma with housing and well-being outcomes in adults with mental illness and recent experience of homelessness.
Mejia-Lancheros C, Lachaud J, Woodhall-Melnik J, O'Campo P, Hwang SW, Stergiopoulos V.
Soc Sci Med. 2020 Oct 20;268:113463. doi: 10.1016/j.socscimed.2020.113463. Online ahead of print.
PMID: 33120207
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2. Interprofessional and multiprofessional approaches in quality improvement education.
Goldman J, Kuper A, Whitehead C, Baker GR, Bulmer B, Coffey M, Shea C, Jeffs L, Shojania K, Wong B.
Adv Health Sci Educ Theory Pract. 2020 Oct 28. doi: 10.1007/s10459-020-10004-z. Online ahead of print.
PMID: 33113055
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3. On the integration of early health technology assessment in the innovation process: reflections from five stakeholders.
Tummers M, Kværner K, Sampietro-Colom L, Siebert M, Krahn M, Melien Ø, Hamerlijnck D, Abrishami P, Grutters J.
Int J Technol Assess Health Care. 2020 Oct 28:1-5. doi: 10.1017/S0266462320000756. Online ahead of print.
PMID: 33109280
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4. Cannabis use and work-related injuries: a cross-sectional analysis.
Zhang JC, Carnide N, Holness L, Cram P.
Occup Med (Lond). 2020 Oct 27:kqaa175. doi: 10.1093/occmed/kqaa175. Online ahead of print.
PMID: 33108459
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5. Instagram as a Window to Societal Perspective on Mental Health, Gender, and Race: Observational Pilot Study.
Utter K, Waineo E, Bell CM, Quaal HL, Levine DL.
JMIR Ment Health. 2020 Oct 27;7(10):e19171. doi: 10.2196/19171.
PMID: 33107831
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6. Pneumocystis jirovecii pneumonia prophylaxis in a 42-year-old woman on immunosuppressive therapy.
Halani S, Andany N, Shah R.
CMAJ. 2020 Oct 26;192(43):E1306-E1308. doi: 10.1503/cmaj.200846.
PMID: 33106302 Free PMC article. No abstract available.
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7. Legal, geographic and organizational contexts that shape knowledge sharing in the hospital discharge process for people experiencing homelessness in Toronto, Canada.
I R Jenkinson J, Strike C, Hwang SW, Di Ruggiero E.
Health Soc Care Community. 2020 Oct 26. doi: 10.1111/hsc.13206. Online ahead of print.
PMID: 33105525
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8. Comorbidities Before and After the Diagnosis of Rheumatoid Arthritis: A Matched Longitudinal Study.
Tatangelo MR, Tomlinson G, Keystone E, Paterson JM, Bansback N, Bombardier C.
ACR Open Rheumatol. 2020 Oct 26. doi: 10.1002/acr2.11182. Online ahead of print.
PMID: 33104286
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9. "This is my home-based exercise": exploring environmental influences on home-based exercise participation in oncology.
Lopez CJ, Pritlove C, Jones JM, Alibhai SMH, Sabiston CM, Chang E, Santa Mina D.
Support Care Cancer. 2020 Oct 23. doi: 10.1007/s00520-020-05843-w. Online ahead of print.
PMID: 33094360
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10. Navigating the roadmap of workplace politics: Advice for new practitioners.
Hecht KN, Bolton SM, Adelman M, Bell CM, McElray KL, Hancock BS, Adams AL.
Am J Health Syst Pharm. 2020 Oct 22:zxaa332. doi: 10.1093/ajhp/zxaa332. Online ahead of print.
PMID: 33091109 No abstract available.
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11. Reproductive patterns, pregnancy outcomes and parental leave practices of women physicians in Ontario, Canada: the Dr Mom Cohort Study protocol.
Cusimano MC, Baxter NN, Sutradhar R, Ray JG, Garg AX, McArthur E, Vigod S, Simpson AN.
BMJ Open. 2020 Oct 21;10(10):e041281. doi: 10.1136/bmjopen-2020-041281.
PMID: 33087379 Free PMC article.
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12. Presence of urinary symptoms in bacteremic urinary tract infection: a retrospective cohort study of Escherichia coli bacteremia.
Bai AD, Bonares MJ, Thrall S, Bell CM, Morris AM.
BMC Infect Dis. 2020 Oct 20;20(1):781. doi: 10.1186/s12879-020-05499-1.
PMID: 33081714 Free PMC article.
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13. Influence of the definition of rurality on geographic differences in HIV outcomes in British Columbia: a retrospective cohort analysis.
Jaworsky D, Loutfy M, Lu M, Ye M, Bratu A, Sereda P, Bayoumi A, Richardson L, Kuper A, Hogg RS; Comparative Outcomes and Service Utilization Trends (COAST) Study.
CMAJ Open. 2020 Oct 19;8(4):E643-E650. doi: 10.9778/cmajo.20200066. Print 2020 Oct-Dec.
PMID: 33077535 Free PMC article.
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14. The Effect of Yoga Interventions on Cancer-Related Fatigue and Quality of Life for Women with Breast Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
O'Neill M, Samaroo D, Lopez C, Tomlinson G, Santa Mina D, Sabiston C, Culos-Reed N, Alibhai SMH.
Integr Cancer Ther. 2020 Jan-Dec;19:1534735420959882. doi: 10.1177/1534735420959882.
PMID: 33073636
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15. Wearable technology and live video conferencing: The development of an affordable virtual teaching platform to enhance clinical skills education during the COVID-19 pandemic.
Wintraub L, Xie M, Issa M, Jeyakumar Y, Nelms M, Sharma D, Teitelbaum D, Otremba M, Sirianni G, Nyhof-Young J, Leung FH.
Can Med Educ J. 2020 Sep 23;11(5):e121-e125. doi: 10.36834/cmej.70554. eCollection 2020 Sep.
PMID: 33062106 Free PMC article. No abstract available.
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16. Value of mesenchymal stem cell therapy for patients with septic shock: an early health economic evaluation.
Thavorn K, van Katwyk S, Krahn M, Mei SHJ, Stewart DJ, Fergusson D, Coyle D, McIntyre L.
Int J Technol Assess Health Care. 2020 Oct 16:1-8. doi: 10.1017/S0266462320000781. Online ahead of print.
PMID: 33059782
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17. Acute COVID-19 and the Incidence of Ischemic Stroke and Acute Myocardial Infarction.
Modin D, Claggett B, Sindet-Pedersen C, Lassen MCH, Skaarup KG, Jensen JUS, Fralick M, Schou M, Lamberts M, Gerds T, Fosbøl EL, Phelps M, Kragholm KH, Andersen MP, Køber L, Torp-Pedersen C, Solomon SD, Gislason G, Biering-Sørensen T.
Circulation. 2020 Oct 15. doi: 10.1161/CIRCULATIONAHA.120.050809. Online ahead of print.
PMID: 33054349 No abstract available.
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18. Developing AHRQ's Feasibility Assessment Criteria for Wide-Scale Implementation of Patient-Centered Outcomes Research Findings.
Fournier AK, Wasserman MR, Jones CF, Beam EL, Gardner EE, Nourjah P, Bierman AS.
J Gen Intern Med. 2020 Oct 13. doi: 10.1007/s11606-020-06247-6. Online ahead of print.
PMID: 33051835
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19. Identity, politics, and the pandemic: Why is COVID-19 a disaster for feminism(s)?
Berkhout SG, Richardson L.
Hist Philos Life Sci. 2020 Oct 13;42(4):49. doi: 10.1007/s40656-020-00346-7.
PMID: 33048278 Free PMC article.
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20. Association of Receipt of Palliative Care Interventions With Health Care Use, Quality of Life, and Symptom Burden Among Adults With Chronic Noncancer Illness: A Systematic Review and Meta-analysis.
Quinn KL, Shurrab M, Gitau K, Kavalieratos D, Isenberg SR, Stall NM, Stukel TA, Goldman R, Horn D, Cram P, Detsky AS, Bell CM.
JAMA. 2020 Oct 13;324(14):1439-1450. doi: 10.1001/jama.2020.14205.
PMID: 33048152
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21. Heterogeneity in testing, diagnosis and outcome in SARS-CoV-2 infection across outbreak settings in the Greater Toronto Area, Canada: an observational study.
Wang L, Ma H, Yiu KCY, Calzavara A, Landsman D, Luong L, Chan AK, Kustra R, Kwong JC, Boily MC, Hwang S, Straus S, Baral SD, Mishra S.
CMAJ Open. 2020 Oct 9;8(4):E627-E636. doi: 10.9778/cmajo.20200213. Print 2020 Oct-Dec.
PMID: 33037070 Free PMC article.
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22. Learning from the Past and Working in the Present to Create an Antiracist Future for Academic Medicine.
Ross PT, Lypson ML, Byington CL, Sánchez JP, Wong BM, Kumagai AK.
Acad Med. 2020 Oct 6. doi: 10.1097/ACM.0000000000003756. Online ahead of print.
PMID: 33031120 No abstract available.
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23. Assumptions About Competency-Based Medical Education and the State of the Underlying Evidence: A Critical Narrative Review.
Brydges R, Boyd VA, Tavares W, Ginsburg S, Kuper A, Anderson M, Stroud L.
Acad Med. 2020 Oct 6. doi: 10.1097/ACM.0000000000003781. Online ahead of print.
PMID: 33031117
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24. Interferon Beta-1b and Lopinavir-Ritonavir for Middle East Respiratory Syndrome.
Arabi YM, Asiri AY, Assiri AM, Balkhy HH, Al Bshabshe A, Al Jeraisy M, Mandourah Y, Azzam MHA, Bin Eshaq AM, Al Johani S, Al Harbi S, Jokhdar HAA, Deeb AM, Memish ZA, Jose J, Ghazal S, Al Faraj S, Al Mekhlafi GA, Sherbeeni NM, Elzein FE, Al-Hameed F, Al Saedi A, Alharbi NK, Fowler RA, Hayden FG, Al-Dawood A, Abdelzaher M, Bajhmom W, AlMutairi BM, Hussein MA, Alothman A; Saudi Critical Care Trials Group.
N Engl J Med. 2020 Oct 22;383(17):1645-1656. doi: 10.1056/NEJMoa2015294. Epub 2020 Oct 7.
PMID: 33026741
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25. Medication Discontinuation in Adults with Chronic Obstructive Pulmonary Disease Discharged from Hospital: A Population-Based Cohort Study.
Gershon AS, McGihon RE, Thiruchelvam D, To T, Wu R, Bell CM, Aaron SD; Canadian Respiratory Research Network.
Chest. 2020 Oct 1:S0012-3692(20)34847-9. doi: 10.1016/j.chest.2020.09.254. Online ahead of print.
PMID: 33011204
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26. Web and phone-based COVID-19 syndromic surveillance in Canada: A cross-sectional study.
Lapointe-Shaw L, Rader B, Astley CM, Hawkins JB, Bhatia D, Schatten WJ, Lee TC, Liu JJ, Ivers NM, Stall NM, Gournis E, Tuite AR, Fisman DN, Bogoch II, Brownstein JS.
PLoS One. 2020 Oct 2;15(10):e0239886. doi: 10.1371/journal.pone.0239886. eCollection 2020.
PMID: 33006990 Free PMC article.
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27. COVID-19 in long-term care homes in Ontario and British Columbia.
Liu M, Maxwell CJ, Armstrong P, Schwandt M, Moser A, McGregor MJ, Bronskill SE, Dhalla IA.
CMAJ. 2020 Sep 30:cmaj.201860. doi: 10.1503/cmaj.201860. Online ahead of print.
PMID: 32998943 No abstract available.
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28. Aggressively find, test, trace and isolate to beat COVID-19.
Matukas LM, Dhalla IA, Laupacis A.
CMAJ. 2020 Oct 5;192(40):E1164-E1165. doi: 10.1503/cmaj.202120. Epub 2020 Sep 9.
PMID: 32907821 Free PMC article. No abstract available.
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29. Anti-Thrombotic Therapy to Ameliorate Complications of COVID-19 (ATTACC): Study design and methodology for an international, adaptive Bayesian randomized controlled trial.
Houston BL, Lawler PR, Goligher EC, Farkouh ME, Bradbury C, Carrier M, Dzavik V, Fergusson DA, Fowler RA, Galanaud JP, Gross PL, McDonald EG, Husain M, Kahn SR, Kumar A, Marshall J, Murthy S, Slutsky AS, Turgeon AF, Berry SM, Rosenson RS, Escobedo J, Nicolau JC, Bond L, Kirwan BA, de Brouwer S, Zarychanski R.
Clin Trials. 2020 Oct;17(5):491-500. doi: 10.1177/1740774520943846. Epub 2020 Aug 20.
PMID: 32815416 Clinical Trial.
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30. Cost-effectiveness of genome-wide sequencing for unexplained developmental disabilities and multiple congenital anomalies.
Li C, Vandersluis S, Holubowich C, Ungar WJ, Goh ES, Boycott KM, Sikich N, Dhalla I, Ng V.
Genet Med. 2020 Oct 28. doi: 10.1038/s41436-020-01012-w. Online ahead of print.
PMID: 33110268
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31. Feeling scared or worried self-report in children receiving cancer treatments using the Symptom Screening in Pediatrics Tool (SSPedi).
Hyslop S, Tomlinson D, Baggott C, Dix D, Gibson P, Johnston DL, Orsey AD, Portwine C, Price V, Vanan M, Kuczynski S, Spiegler B, Tomlinson GA, Dupuis LL, Sung L.
Support Care Cancer. 2020 Oct 17. doi: 10.1007/s00520-020-05818-x. Online ahead of print.
PMID: 33067767
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32. Effect of Driving Pressure Change During Extracorporeal Membrane Oxygenation in Adults With Acute Respiratory Distress Syndrome: A Randomized Crossover Physiologic Study.
Del Sorbo L, Goffi A, Tomlinson G, Pettenuzzo T, Facchin F, Vendramin A, Goligher EC, Cypel M, Slutsky AS, Keshavjee S, Ferguson ND, Fan E; International ECMO Network (ECMONet).
Crit Care Med. 2020 Oct 12. doi: 10.1097/CCM.0000000000004637. Online ahead of print.
PMID: 33044283
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33. Eosinophils in Transbronchial Biopsies: A Predictor of Chronic Lung Allograft Dysfunction and Reduced Survival After Lung Transplantation.
Darley DR, Ma J, Huszti E, Fiset P, Levy L, Hwang DM, Pal P, Klement W, Zamel R, Keshavjee S, Tomlinson G, Singer LG, Tikkanen JM, Martinu T.
Transpl Int. 2020 Oct 6. doi: 10.1111/tri.13760. Online ahead of print.
PMID: 33025592
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34. Endometriosis recurrence following post-operative hormonal suppression: a systematic review and meta-analysis.
Zakhari A, Delpero E, McKeown S, Tomlinson G, Bougie O, Murji A.
Hum Reprod Update. 2020 Oct 6:dmaa033. doi: 10.1093/humupd/dmaa033. Online ahead of print.
PMID: 33020832 |
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35. Journey into the unknown: Considering the international medical graduate perspective on the road to Canadian residency during the COVID-19 PANDEMIC.
Gutman, A., Tellios, N., Sless, R.T., Najeeb, U. (2020)
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Trainee Publications
1. Rationale and design of repeated cross-sectional studies to evaluate the reporting quality of trial protocols: the Adherence to SPIrit REcommendations (ASPIRE) study and associated projects.
Gryaznov D, Odutayo A, von Niederhäusern B, Speich B, Kasenda B, Ojeda-Ruiz E, Blümle A, Schandelmaier S, Mertz D, Tomonaga Y, Amstutz A, Pauli-Magnus C, Gloy V, Bischoff K, Wollmann K, Rehner L, Lohner S, Meerpohl JJ, Nordmann A, Klatte K, Ghosh N, Heravi AT, Wong J, Chow N, Hong PJ, Cord KM, Sricharoenchai S, Busse JW, Agarwal A, Saccilotto R, Schwenkglenks M, Moffa G, Hemkens LG, Hopewell S, von Elm E, Briel M.
Trials. 2020 Oct 28;21(1):896. doi: 10.1186/s13063-020-04808-y. PMID: 33115541
2. COVID-19 exposing cracks in our universal healthcare. Healthy Debate. 2020
Hudson G, Cheff R, Saposan M, Agarwal A
3. Clinical Trial Evidence Supporting US Food and Drug Administration Approval of Novel Cancer Therapies Between 2000 and 2016.
Ladanie A, Schmitt AM, Speich B, Naudet F, Agarwal A, Pereira TV, Sclafani F, Herbrand AK, Briel M, Martin-Liberal J, Schmid T, Ewald H, Ioannidis JPA, Bucher HC, Kasenda B, Hemkens LG.
JAMA Netw Open. 2020 Nov 2;3(11):e2024406.
doi: 10.1001/jamanetworkopen.2020.24406. PMID: 33170262
4. Prognostic factors for severity and mortality in patients infected with COVID-19: A systematic review.
Izcovich A, Ragusa MA, Tortosa F, Lavena Marzio MA, Agnoletti C, Bengolea A, Ceirano A, Espinosa F, Saavedra E, Sanguine V, Tassara A, Cid C, Catalano HN, Agarwal A, Foroutan F, Rada G.
PLoS One. 2020 Nov 17;15(11):e0241955.
doi: 10.1371/journal.pone.0241955. eCollection 2020.PMID: 33201896
5. A living WHO guideline on drugs for COVID-19
Rochwerg B, Agoritsas T, Lamontagne F, Leo YS, Macdonald H, Agarwal A, Zeng L, Lytvyn L, Appiah JA, Amin W, Arabi Y, Blumberg L, Burhan E, Bausch F, Calfee CS, Cao B, Cecconi M, Chanda D, Cooke G, Du B, Dunning J, Geduld H, Gee P, Hashimi M, Hui DS, Kabra S, Kanda S, Kawano-Dourado L, Kim YJ, Kissoon N, Kwizera A, Laake JH, Machado FR, Mahaka I, Manai H, Mino G, Nsutebu E, Pshenichnaya N, Qadir N, Sabzwari S, Sarin R, Sharland M, Shen Y, Ranganthan SS, Souza J, Ugarte S, Venkatapuam S, Dat VQ, Vuyiseka D, Wuewickrama A, Maguire B, Zeraatkar D, Bartoszko J, Ge L, Brigardello-Peterson R, Siemieniuk R, Guyatt GH, Diaz J, Jacobs M, Vandvik PO.
[first update].BMJ. 2020 Nov 20;370;m3379 [Epub ahead of print].
6. Therapeutics and COVID-19: living guideline.
World Health Organization methods resource team: Geneva, Switzerland: World Health Organization Headquarters. 2020 Nov 20 . Agarwal A; NMA team: Agarwal A].
7. Pneumocystis jirovecii pneumonia prophylaxis in a 42-year-old woman on immunosuppressive therapy.
Halani S, Andany N, Shah R.
CMAJ. 2020 Oct 26;192(43):E1306-E1308. doi: 10.1503/cmaj.200846.
PMID: 33106302 Free PMC article. No abstract available.
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For future newsletters, please email information on your contributions to joe.graves@uhn.ca.
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