Paediatric Gastroenterology The contents of this brochure include • Information on Calgary • Details about the Department of Paediatrics and the facilities it works out of • Information about the Physician Team and personnel of the Gastroenterology Section • Education & Training information • Programs, Services & Clinics offered • Contact information
Department of Paediatrics
Department of Paediatrics Calgary Zone
The Department has four fundamental activities: • Provision of all levels of clinical services to infants, children and adolescents in Calgary, throughout Alberta and other Provinces • Training the next generation of healthcare professionals caring for children and their families, and continued training for current healthcare professionals • Knowledge generation and innovation in clinical care and education through the conduct, dissemination and translation of research • Provision of leadership throughout clinical and academic health systems. We have grown to over 300 clinical and academic faculty members in 20 clinical sections and divisions, and 2 academic units. The hub of our clinical services is the 135 bed Alberta Children’s Hospital which last year (2011-12) received over 237,000 outpatient clinic visits, over 65,000 emergency department visits and 7300 admissions. We provide neonatal intensive care unit (NICU) care at the Alberta Children’s Hospital, Foothills Medical Centre, Peter Lougheed Centre and Rockyview General Hospital. Last year, nearly 3000 babies were served in our NICUs. We also provide paediatric inpatient service at the Peter Lougheed Centre, as well as general paediatric and subspecialty ambulatory clinical services throughout Calgary. We provide palliative and respite care at the Rotary Flames House, located beside ACH. Our physicians travel to provide hundreds of outreach clinics throughout southern Alberta. The population we serve continues to grow. Last year there were over 18,000 births in the Calgary zone. The Government of Alberta estimates that the number of births will continue to increase to nearly 20,000 per year by 2021 and that the number of infants, children and youth aged 19 and under will increase by 20% from 333,530 in 2012 to 399,590 in 2021 (“Alberta Population Projection 2012-2041”). We teach health professionals at all levels throughout the University of Calgary, as well as SAIT and Mount Royal College. There are 12 Royal College of Physicians and Surgeons of Canada Paediatric Residency Training Programs in Calgary (http://medicine.ucalgary.ca/postgrad). In 2011-12, 93 medical residents and fellows were being trained. Department members initiate or participate in biomedical, clinical, health services and population/public health research. Our main research partner is the ACH Research Institute for Child and Maternal Health (ACHRI, www.ucalgary.ca/research4kids/). The Alberta Children’s Hospital Foundation provides generous support to services in the hospital and to research (www.childrenshospital.ab.ca). Funding of faculty in the Department of Paediatrics is complex. Fee-for-service funding remains the main source of funding. The Paediatric Academic Alternate Relationship Plan (Academic ARP) supports about 100 FTEs. There are separate Clinical ARPs for each of Neonatology and the Paediatric Intensive Care Unit. The Sections of Hospital Paediatrics and Medical Genetics each have an Alternate Payment Plan (APP). Several PhD members of the Department are supported by the ACH Research Institute (ACHRI) and several department members have salary awards from external research agencies.
Overall, we are able to provide excellent clinical care to the children and families who we serve. We also make excellent contributions to education, research, advocacy and medical leadership. Our workforce has increased substantially over the last decade. Our main challenges, at the end to 2012, are two-fold. First, the facilities and institutions built to support Paediatric services in Calgary and area are strained. The population growth over the last decade far exceeded projections and growth continues, at a time when there are limited opportunities to increase Paediatric facilities. Second, the outlook for funding of academic departments in Alberta (through AARPS) is currently very uncertain and the outlook for overall physician services funding in Alberta is unsettled.
Our Hospitals and facilities Alberta Children’s Hospital The Alberta Children’s Hospital opened in Calgary, Alberta in September 2006, becoming the first free-standing paediatric facility to be built in Canada in more than 20 years. Family centred care is a philosophy celebrated by the Alberta Children’s Hospital, which recognizes the important role families play in the physical, psychological and spiritual well being of their children. This model of care embraces family members as key partners in a child’s healing team. This philosophy is most evident in the actual design of the building. The hospital was designed by the people who use the building the most — kids, families, physicians and staff. The colourful lego-inspired building has become a Calgary landmark and one that is unique in every way. Over 82,000 kids rely on care from the hospital each year and you can help assure the long-term health of our children. This philosophy is most evident in the actual design of the building. The hospital was designed by the people who use the building the most — kids, families, physicians and staff. The colourful lego-inspired building has become a Calgary landmark and one that is unique in every way. Over 82,000 kids rely on care from the hospital each year and you can help assure the long-term health of our children. The Alberta Children’s Hospital is used by patients from birth to age 18 from across Alberta, southeastern British Columbia and south-western Saskatchewan as multi-disciplinary teams work together to promote healing through family centred care.
A History of the Alberta Children’s Hospital While today, the Alberta Children's Hospital is a world-class Paediatric facility, caring for more than 75,000 children and families each year, it has evolved from very humble beginnings. Our first hospital opened in 1922 and was known as the Junior Red Cross Children's Hospital. It was originally a three-storey home at 522 - 18 Avenue SW, had 35 beds, and was run by volunteer physicians. Seven years later, as demands for children's health care increased, the hospital was moved to a renovated apartment house on 20th Avenue SW. It was renamed the Red Cross Crippled Children's Hospital. The former Richmond Road site began taking shape in 1952 when provincial and federal grants resulted in the construction of two wings. Five years later, the Red Cross discontinued sponsorship support of the hospital and the hospital was registered under the Societies Act as a non-profit organization and renamed the Alberta Crippled Children's Hospital. The non-profit organization was named the Alberta Children's Provincial General Hospital Society and eventually became known as the Alberta Children's Hospital Foundation. By 1960, the hospital took the name it holds today: the Alberta Children's Hospital. In 1972, the provincial government purchased the hospital for $2 million from the Foundation who used the revenue to create an endowment fund. Support from the Foundation to the hospital has continued ever since. In the early years, children with septic tonsils, polio and club foot accounted for most of the hospital admissions. Patients stayed on average from one to two months. Today, the Alberta Children's Hospital provides a complete range of medical, surgical and diagnostic services. Because children heal better at home, specialists make every effort now to minimize the length of hospital stay for patients and provide expert care through the hospital's out-patient clinics.
Rockyview General Hospital (RGH) is a large hospital in Alberta, Canada. It is located in the city of Calgary, on the shores of the Glenmore Reservoir and is administered by Alberta Health Services and formerly by the Calgary Health Region. The hospital contains over 650 beds and provides medical and surgical services to Calgary and Southern Alberta. The RGH is noted for its comprehensive urology department, and is becoming the leader in Canada for urological care. It includes a 24 hours emergency department, an intensive care unit (ICU), as well as day surgery units. It offers a Maternal Newborn Program, mental health and psychiatric services, as well as senior's health and ambulatory care.
Additionally, the Lions Eye Bank, which is a regional centre for recovery of donated eye tissue for corneal transplants, is located at RGH. The building was designed by Culham Pedersen Valentine, and built at a cost of $90 million. It had a total surface of 69,952 m2 (752,960 sq ft), and an additional 23,000 m2 (250,000 sq ft) were added in 1995. Further expansion in 2004 added another 100 beds. The hospital is undergoing expansion and upgrades, with two operating theatres to be added to the surgical suite, and vertical expansion of the Highwood Building. In addition, the expansion will include an added 100 inpatient beds, as well as 3 stories added to the hospital's North Tower, and 5 stories to the South side of the hospital. Clinics • • • • • • • • • • • • • • • • • • •
Breast Feeding Bronchoscopy Cast Cystoscopy Enterostomal Therapy Emergency Cast GeneralAnte-partum GeneralCardiology Hand Home Visit Infectious Disease MedicalGeriatric OBS Gyne Ophthalmology Orthopedic Outreach Pacemaker Pain Pre op Assessment
In addition, ambulatory care includes Medicine, Respiratory, GI/GU, Surgery, Diabetes in Pregnancy, Pulmonary Respiratory Exercise Program, Lithotripsy, Pacemaker Clinic, Paediatric Clinic, Geriatric Outpatient Consultation and Geriatric Mental Health
Peter Lougheed Centre (PLC) is a large hospital in Alberta, Canada. It is located in the City of Calgary, and runs under the auspices of Alberta Health Services, formerly the Calgary Health Region, providing medical and surgical services not only to Calgary, but also Southern Alberta. The PLC has a 24 hours emergency department, an intensive care unit (ICU), Level IV trauma centre and offers ambulatory care. It was named after the late Peter Lougheed, who served as premier of Alberta from 1971 to 1985. The hospital opened in 1988 with 500 beds, and today contains over 600 beds. The new East Wing was completed in 2008 and includes 140 inpatient beds, as well as a new intensive care and coronary care unit. It was also designed with a new roof-top helipad for emergency services. Clinics • • • • • • • • • • • • • • • •
Adult Congenital Heart Amputee Asthma/Lung Health Behavioral Development Breast Feeding Bronchoscopy Cardiology Cast Cystoscopy Diabetes in Pregnancy Emergency Cast Enterostomal Therapy Family Day Medicine Fetal Assessment General Surgery • Geriatric Assessment Gerontology
• • • • • • • • • • • • • • • • •
Hand Plastics Hematology/Oncology Home Parenteral Therapy Program Minor Surgery Neurology Obstetrical Assessment Outpatient Carbogen Pacemaker Paediatric and Adult Pre op Assessment Private Paediatric Psychiatric Day Psychiatric Emergency Psychiatric Forensic Assess Psychiatric Outpatient Services Rheumatology Tracheostomy Urgent Referral
In addition, ambulatory care includes Cardiac Diagnostics, Medicine, Respiratory, GI, Neurodiagnostics and Gynecology Outpatient services.
Foothills Medical Centre
Credits: LYLE ASPINALL/CALGARY SUN/QMI AGENCY
In addition to a 24-hour emergency room and inpatient care, FMC has 57 outpatient clinics on site. This facility provides comprehensive and specialized medical and surgical services to Calgary and Southern Alberta: • • • • • • • •
26 bed intensive care unit and 24 bed cardiac care unit Trauma centre for Southern Alberta 18 operating theatres - including a specially designated trauma operating room High risk maternity and neonatal intensive care unit PARTY Program (Prevent Alcohol & Risk Related Trauma in Youth Program for Grade 9 secondary school students) PADIS (poison & drug information) Southern Alberta Renal Program Intraoperative MR - magnetic resonance system (first of its kind in the world, located in the Seaman's Family MR Research Centre)
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• • • •
Stephenson Cardiac MR Centre - the leading cardiac magnetic resonance facility in Canada, as measured by number of peer-reviewed articles published, and part of the Libin Cardiovascular Institute of Alberta Multiple transplantation such as kidney, pancreas, corneal and tissue transplants. HOPE Program (Human Organ Procurement and Exchange) University of Calgary Medical Clinic (UCMC) clinics The Colon Cancer Screening Centre - providing screening colonoscopies to hundreds of patients a month.
Foothills Medical Centre (FMC) is the largest hospital in Alberta, Canada and is located in the City of Calgary. It is one of Canada's most recognized medical facilities and is one of the leading hospitals in Alberta, providing advanced healthcare services to over two million people from Calgary, Southern Alberta, south-eastern British Columbia, and southern Saskatchewan. Formerly operated by the Calgary Health Region, it is now under the authority of Alberta Health Services. The main building of the hospital was opened in June 1966. It was originally named 'Foothills Provincial General Hospital' and later known simply as Foothills Hospital. With the addition of other medical facilities, it became known by its present name. Foothills Medical Centre is an accredited tertiary Level 1 trauma centre by the Trauma Association of Canada and is the largest regional trauma centre in Southern Alberta. In addition, FMC is accredited by Accreditation Canada for stroke rehabilitation. FMC works in conjunction with the nearby University of Calgary for the purposes of educating students as well as providing facilities for medical research. FMC includes the University of Calgary Medical Centre (UCMC) as well as the Special Services Building (where most other medical services are provided) and the Tom Baker Cancer Centre, which was renamed the "Cancer Centre", and is a leading centre in Alberta for cancer treatment and research. The large site also features Grace Women's Health Centre, which specializes in women's health, the Health Sciences Association of Alberta, as well as both the North Tower and South Tower, which offer many outpatient services. The head office of Libin Cardiovascular Institute of Alberta is located on the 8th floor of the Foothills Medical Centre. The TRW Building was also added to the Health Sciences building, which was completed in late 2005. In addition, the new McCaig Tower opened in October 2010 with 93 inpatient beds, 36 bed intensive care unit (only 25 funded by the Government of Alberta), 21 short-stay beds (a total of 150 additional beds), as well as 8 operating rooms. In November 2011, the newly designed Intensive Care Unit (ICU) was awarded the 2012 Design Citation for being "one of the best in the world". The neighbouring Alberta Children's Hospital and west side of the University of Calgary campus are accessible from FMC via West Campus Boulevard.
Apart from these distinctions, FMC boasts the world's first and most powerful movable MRI machine, which was introduced in January 2009. It will help patients at the Foothills Medical Centre (FMC) receive the world’s safest, most accurate surgery possible. In addition, the world's first robotic surgery was also performed on a patient at the FMC for a removal of a brain tumour, which also created a landmark in Canadian medical history. In June 2010, the Calgary Stroke Program, an initiative of the Foothills Medical Centre, was awarded the "Stroke Services Distinction" and is recognized as one of two leading stroke centres in Canada, the other in Toronto, by Accreditation Canada.
South Health Campus Construction of South Health Campus (SHC) began in August of 2007, and at the end of 2012 and the beginning of 2013 its doors are beginning to open. SHC is modeled on a somewhat different philosophy than the traditional hospital based on four foundational pillars of care. These pillars include Collaborative Practice, Innovation, Patient & Family Centered Care and Wellness. The goal is to deliver services within the community surrounding SHC by integrating leading technology, research and education with the unique healing environments that are facilitated at the site and a progressive, environmental design. As soon as you walk into the building there is a feeling of a community fostered by its unique design. An in house YMCA with a climbing wall, large open spaces, single bed patient rooms with exterior views, wide corridors, gardens and artwork throughout the building and a retail space made to feel more like a cafĂŠ, is all part of the design created to provide wellness, knowledge and education to all who are there.
Other services are also available including health resources and knowledge centers and an interactive and demonstrative wellness kitchen. Collaborative Practice includes ensuring safe and quality care, a focus on patient and family centered care, joint decision making, as well as respecting and valuing the different roles of the patients and all health care providers. A trusting and open communication style along with sharing accountability in a just and equitable way for patient care is also a large component of this pillar of collaborative practice. Innovation can mean a number of things; it can be the ability to make changes that result in a more effective type of patient care or looking at how we are doing things with a new lens and determining how we can improve patient care. It could be incorporating a new idea into a patient’s care or perhaps using an existing idea that is present in the region or even nationally or internationally, but applying it in a new setting. The last of these foundational pillars is Family and Patient Centered Care. This goal is for families to be partners in care in a supportive and respective environment for patients and health care providers. There has been a new approach taken to the communication style between staff as well as between staff and patients. A new method known as NOD has been adopted. NOD stands for Name, Occupation and Duty. When providers arrive at a patient’s door they will tell families who they are, their role and why they are there. A communication white board will also be at every bedside so that families’ questions can be addressed appropriately and to ensure clear communication lines between all those providing care. A Citizen Advisory Team is also going to advise on how to enhance things for patients and families being cared for in the hospital. Dr. Harish Amin is the Medical Site Lead for Paediatrics at the South Health Campus and Department of Paediatrics at the South Health Campus Special Feature has been a leader in facilitating and educating individuals on the role of the Department of Paediatrics at this new site. Paediatric Emergency is housed within the Emergency Department at SHC and opened with all Emergency services on January 14, 2013. In its first three days after opening 30% of all emergency visits have been paediatric patients. It is anticipated that it will get busier but currently Paediatric Emergency physicians offer 12 hours of coverage in the department daily. General and subspecialty clinics will be opening around the end of May 2013 and are all housed on the 7th floor of SHC along with the 16 bed Level II Neonatal Intensive Care Unit (NICU). It is projected that the NICU will open along with labor and delivery services on September 3, 2013. Some clinics that will be offered at SHC include Asthma, Neurology, General Paediatrics, Weight Management and some Nephrology clinics. As more subspecialists come on board with recruitment the hope is to also offer other subspecialtyclinics includingAllergy and Immunology and DevelopmentalPaediatrics Clinics starting in 2014.
The Rotary Flames House (RFH) is a hospice that serves families from Alberta caring for a child 0-17 years old with a progressive life-threatening or life-limiting condition. The Rotary Flames House is situated in the Northeast corner of the Alberta Children's Hospital grounds, directly across from the helicopter pad. It is modeled after a two-storey home and is designed to be a place of sanctuary for families and children. Care is provided 24 hours a day, 7 days a week by a team of trained healthcare professionals in a supportive, welcoming, and friendly environment. Rotary Flames House is home to the Children's Hospice and Palliative Care Service (CHaPS). CHaPS provides a comprehensive palliative care program for children with life-threatening illness and their families across the continuum of care. These consist of: Palliative Care Consultation Service The palliative care consultation service is comprised of specialized palliative care physicians, nurses, social workers and chaplains who provide a collaborative, comprehensive team approach to confronting the challenging issues around a child's serious illness and possible death. Grief Support Program The grief support program is available to provide support to all families who have a child who has died. Bereavement support is offered in many ways to fit the unique needs of the family, such as individual, family and/or group counseling, resourcing/education and referrals to community agencies. Family support provided at Rotary Flames House includes: • Planned and emergency respite • Short term transitional care between hospital and home • Symptom management • Grief and bereavement support • Specialized end of life care that honors the primary role of the family and community.
About Calgary The City of Calgary’s 2012 municipal census counted a population of 1,120,225, a 2.7% increase over its 2011 municipal census population of 1,090,936. The city is among the sunniest in Canada, with 2,405 hours of annual sunshine, on average. Sports, Recreation & Attractions In large part due to its proximity to the Rocky Mountains, Calgary has traditionally been a popular destination for winter sports. Since hosting the 1988 Winter Olympics, the city has also been home to a number of major winter sporting facilities such as Canada Olympic Park (bobsleigh, luge, cross-country skiing, ski jumping, downhill skiing, snowboarding, and some summer sports) and the Olympic Oval (speed skating and hockey). These facilities serve as the primary training venues for a number of competitive athletes. Also, Canada Olympic Park serves as a mountain biking trail in the summer months. In the summer, the Bow River is very popular among fly-fishermen. Golfing is also an extremely popular activity for Calgarians and the region has a large number of courses. Calgary hosted the 2009 World Water Ski Championship Festival in August, at the Predator Bay Water Ski Club which is situated approximately 40 km (25 mi) south of the city. As part of the wider Battle of Alberta, the city's sports teams enjoy a popular rivalry with their Edmonton counterparts, most notably the rivalries between the National Hockey League's Calgary Flames and Edmonton Oilers, and the Canadian Football League's Calgary Stampeders and Edmonton Eskimos. The city also has a large number of urban parks including Fish Creek Provincial Park, Nose Hill Park, Bowness Park, Edworthy Park, the Inglewood Bird Sanctuary, Confederation Park, and Prince's Island Park. Nose Hill Park is the largest municipal park in Canada. Connecting these parks and most of the city's neighbourhoods is one of the most extensive multi-use (walking, bike, rollerblading, etc.) path systems in North America. Downtown features an eclectic mix of restaurants and bars, cultural venues, public squares (including Olympic Plaza) and shopping. Notable shopping areas include such as The Core Shopping Centre (formerly Calgary Eaton Centre/TD Square), Stephen Avenue and Eau Claire Market. Downtown tourist attractions include the Calgary Zoo, the Telus World of Science, the Telus Convention Centre, the Chinatown district, the Glenbow Museum, the Calgary Tower, the Art Gallery of Calgary (AGC), Military Museum and the EPCOR Centre for the Performing Arts. At 2.5 acres (10,000 m2), the Devonian Gardens is one of the largest urban indoor gardens in the world, and it is located on the 4th floor of The Core Shopping Centre (above the shopping). The downtown region is also home to Prince's Island Park, an urban park located just north of the Eau Claire district. Directly to the south of downtown is Midtown and the Beltline. This area is quickly becoming one of the city's densest and most active mixed use areas.
At the district's core is the popular "17 Avenue", which is known for its many bars and nightclubs, restaurants, and shopping venues. During the Calgary Flames' playoff run in 2004, 17 Avenue was
frequented by over 50,000 fans and supporters per game night. The concentration of red jerseywearing fans led to the street's playoff moniker, the "Red Mile." Downtown is easily accessed using the city's C-Train light rail (LRT) transit system. Attractions on the west side of the city include the Heritage Park Historical Village historical park, depicting life in pre-1914 Alberta and featuring working historic vehicles such as a steam train, paddle steamer and electric streetcar. The village itself comprises a mixture of replica buildings and historic structures relocated from southern Alberta. Other major city attractions include Canada Olympic Park, which features Canada's Sports Hall of Fame, and Spruce Meadows. Calgary has a number of multicultural areas. Forest Lawn is among the most diverse areas in the city and as such, the area around 17 Avenue SE within the neighbourhood is also known as International Avenue. The district is home to many ethnic restaurants and stores. Calgary was designated as one of the cultural capitals of Canada in 2012. Calgary is the site of the Southern Alberta Jubilee Auditorium performing arts, culture and community facility. The auditorium is one of two "twin" facilities in the province, the other located in Edmonton, each being locally known as the "Jube." The 2,538-seat auditorium was opened in 1957 and has been host to hundreds of Broadway musical, theatrical, stage and local productions. The Calgary Jube is the resident home of the Alberta Ballet Company, the Calgary Opera, the Kiwanis Music Festival, and the annual civic Remembrance Day ceremonies. Both auditoriums operate 365 days a year, and are run by the provincial government. Both received major renovations as part of the province's centennial in 2005. The city is also home to a number of theatre companies; among them are One Yellow Rabbit, which shares the EPCOR Centre for the Performing Arts with the Calgary Philharmonic Orchestra, as well as Theatre Calgary, Alberta Theatre Projects and Theatre Junction Grand, culture house dedicated for the contemporary live arts. Calgary was also the birthplace of the improvisational theatre games known as Theatresports. The Calgary International Film Festival is also held in the city annually, as well as the International Festival of Animated Objects. Every three years, Calgary hosts the Honens International Piano Competition (formally known as the Esther Honens International Piano Competition). The finalists of the competition perform piano concerto with the Calgary Philharmonic Orchestra; the laureate is awarded a cash prize (currently $100,000.00 CDN, the largest cash award of any international piano competition), and a three year career development program. The Honens is an integral component of the classical music scene in Calgary. Photo credit: Photo of Railway Prairie Town recreation, Heritage Park, Calgary, Alberta, Canada Courtesy of Qyd via Wikimedia Commons
Visual and conceptual artists like the art collective United Congress are active in the city. There are a number of art galleries in the downtown, many of them concentrated along the Stephen Avenue and 17 Avenue corridors. The largest of these is the Art Gallery of Calgary (AGC). Calgary is also home to the Alberta College of Art and Design. Calgary is also home to a vibrant choral music community, including a variety of amateur, community, and semi-professional groups. Some of the mainstays include the Mount Royal Choirs from the Mount Royal University Conservatory, the Calgary Boys' Choir, the Calgary Girls Choir, the Youth Singers of Calgary, the CantarĂŠ Children's Choir, and Spiritus Chamber Choir. Calgary hosts a number of annual festivals and events. These include the Calgary International Film Festival, the Calgary Folk Music Festival, FunnyFest Calgary Comedy Festival, the Folk Music Festival, the Greek Festival, Carifest, Wordfest: Banff Calgary International Writers Festival, the Lilac Festival, GlobalFest, the Calgary Fringe Festival, Summerstock, Expo Latino, Calgary Gay Pride, Calgary International Spoken Word Festival, and many other cultural and ethnic festivals. Calgary's best-known event is the Calgary Stampede, which has occurred each July since 1912. It is one of the largest festivals in Canada, with a 2005 attendance of 1,242,928 at the 10-day rodeo and exhibition. Several museums are located in the city. The Glenbow Museum is the largest in western Canada and includes an art gallery and First Nations gallery. Other major museums include the Chinese Cultural Centre, the largest stand-alone cultural centre in Canada), the Canadian Olympic Hall of Fame and Museum (at Canada Olympic Park), The Military Museums, the Cantos Music Museum and the Aero Space Museum.
Prince of Wales and Lieutenant-Governor Egbert, Calgary, Alberta - Glenbow Archives NB-16-76
Downtown Downtown can be recognized by its numerous skyscrapers. Some of these structures, such as the Calgary Tower and the Scotiabank Saddledome are unique enough to be symbols of Calgary. Office buildings tend to concentrate within the commercial core, while residential towers occur most frequently within the Downtown West End and the Beltline, south of downtown.
buildings are iconographic of the city's booms and busts, and it is easy to recognize the various phases of development that have shaped the image of downtown. The first skyscraper building boom occurred during the late 1950s and continued through to the 1970s. After 1980, during the recession, many high-rise construction projects were immediately halted. It was not until the late 1980s and through to the early 1990s that major construction began again, initiated by the 1988 Winter Olympics and stimulated by the growing economy. To connect many of the downtown office buildings, the city also boasts the world's most extensive skyway network (elevated indoor pedestrian bridges), officially called the +15. The name derives from the fact that the bridges are usually 15 ft (4.6 m) above grade. In addition to the many shopping areas in the city centre, there are a number of large suburban shopping complexes in the city. Among the largest are Chinook Centre and Southcentre Mall in the south, Westhills and Signal Hill in the southwest, South Trail Crossing and Deerfoot Meadows in the southeast, Market Mall in the northwest, Sunridge Mall in the northeast, and the newly built CrossIron Mills just north of the Calgary city limits, and south of the City of Airdrie.In nearby Airdrie at the Calgary/Airdrie Airport the Airdrie Regional Air show is held every two years. In 2011 the air show featured the Canadian Snowbirds, a CF-18 demo and a United States Air Force F-16.
Gastroenterology Department Physician/Faculty Listing
Dr. Steven Martin*- Section Chief Dr. Leanna McKenzie* - PGME Program Director Dr. Dana Boctor* Dr. Decker Butzner* Dr. Jennifer DeBruyn* Dr. Helen Machida* Dr. Brent Scott* Dr. Chris Waterhouse* Dr. Iwona Wrobel* Dr. Alfred Yeung*
**Paediatric AARP Members *Paediatric AARP Members #Part-Time or Associate Sectional Members
Programs, Services & Clinics Provided The Section of Gastroenterology, Hepatology, and Nutrition at Alberta Children’s Hospital provides consultant inpatient and outpatient care for children in Southern Alberta and neighbouring Saskatchewan and Eastern British Columbia with disorders of the gastrointestinal tract and liver including: Celiac disease
Chronic constipation
Chronic liver and biliary disease
Chronic pancreatitis
Cystic fibrosis
Eosinophilic gastrointestinal disorders
Foreign body and caustic ingestions
Functional gastrointestinal and motility disorders
Gastrointestinal bleeding
Gastrointestinal polyps
Gastroesophageal reflux disease
Inflammatory bowel disease
Intestinal failure/Short bowel syndrome
Peptic ulcer disease
Specialty programs and clinics are offered directly or in collaboration with other medical specialties including: Clinics • • • •
Chronic Abdominal Pain Cystic Fibrosis Esophageal Atresia Paediatric Gastroenterology Outreach (Lethbridge, Medicine Hat)
Programs • • • •
Children’s Hospital Intestinal Rehabilitation Program (CHIRP) Gastrointestinal Motility Centre Paediatric Inflammatory Bowel Disease Transition Program Southern Alberta Parenteral Home Nutrition Program (SAPHN)
Diagnostic investigations areoordinated c through the Gastroenterology Lab and include: • Endoscopy services • Gastrointestinal motility testing • Hydrogen Breath Testing
Education Details regarding the Paediatric Gastroenterology, Hepatology and Nutrition Section's PGME program can be read below. Program Director Dr. Leanna McKenzie Alberta Children's Hospital 2888 Shaganappi Trail NW Calgary AB T3B 6A8 Phone: (403) 955-7721 Fax: (403) 955-2922 e-mail: leanna.mckenzie@albertahealthservices.ca
Program Administrator: Ms. Pamela White
For further information see also: Department of Paediatrics Main site: http://ucalgary.ca/paed/
http://www.calgaryhealthregion.ca/clin/child/paed (click on Directory)
Department of Paediatrics Education page: http://ucalgary.ca/paed/education
Canadian Resident Matching Service (CaRMS) http://www.carms.ca (click on Directory)
Phone: (403) 955-7301 e-mail: pamela.white@albertahealthservices.ca
Medical Students and Clinical Clerks The section of Paediatric Gastroenterology, Hepatology and Nutrition accepts third and fourth year medical students in their clinical clerkship for electives. Medical students should have completed their core Paediatric rotation before their elective in Paediatric GI. Students are accepted on a firstcome, first serve basis. Electives in Paediatric GI will consist of the following elements: Inpatient Wards : As a clinical clerk, you will be expected to perform initial consults and follow up on patients under our care. The most senior trainee on the ward rotation (fellow or resident) is in charge of managing the GI team, delegating consults, and ensuring all patients have been adequately followed up. As a clerk, you will be assigned specific patients to follow and be expected to perform new consults. Outpatient GI clinic : If your rotation is longer than 1 week, you are likely to be booked into four outpatient clinic days. Clinics occur on Mondays to Thursdays and are full day clinics. Our administrative assistant will distribute this schedule to you beforehand so you are aware of the expectation. Endoscopy and Procedures : You are invited to observe endoscopy and other procedures in the Operating Room or the GI lab. Over the course of the elective, you may be exposed to gastroscopy, colonoscopy, and therapeutic endoscopy and motility studies. Teaching : On Fridays from 8am to 12 pm, the GI Division has academic half day teaching. These mandatory teaching rounds are on a wide variety of topics and you will be notified of the schedule via email each week. You are encouraged to read about the topics beforehand to enhance your learning experience. Call: As a clinical clerk, you are not required to perform call, however if this interests you, please discuss it with the fellow or physician on call. Objectives and Goals : Over the course of your rotation, the GI Division will familiarize you with common and some uncommon gastrointestinal, liver, nutritional, and metabolic diseases that occur in the Paediatric patient. It is recommended that you meet with your preceptor at the start of the rotation to discuss your objectives for the rotation.
CanUC-Peds has an online list of curriculum objectives. Clinical clerks are expected to have a systematic approach (including differential diagnosis, investigations and management) to each of these problems. These objectives primarily related to our section include the following: Neonatal Jaundice Abdominal Pain Diarrhoea
Growth Problems Vomiting
Research: Clerks wishing to perform small clinical projects or prepare a case report for publication should not hesitate to approach a staff to discuss potential opportunities. Such projects could be performed throughout the year and need not be limited to the period of the rotation. Evaluation: Our division is committed to providing you a timely evaluation. Two to three days before your last day of the rotation, please ask your preceptor if you can establish a time to review your evaluation. It is critical that you: 1) notify the physician that you are ending the rotation and set an appointment to discuss your evaluation 2) provide your preceptor with an evaluation (or on-line) form. The preceptor should also provide you with interim feedback. If s/he does not discuss a mid-way assessment, please ask for feedback. Contact: Ms. Pamela White - Program Administrator Paediatric Gastroenterology pamela.white@albertahealthservices.ca (403) 955-7301 Once the elective is confirmed with the administrator, you will need to follow up with the UME (Undergraduate Medical Education) office for further instruction. Refer to e-mail below. E-Mail: visting@ucalgary.ca
Paediatric Residents
The section of Paediatric Gastroenterology, Hepatology and Nutrition accepts Paediatric residents for one month clinical elective experiences. Residents are accepted on a first-come, first-served basis. Processing requirements for Electives can be seen here by following this URL: http://www.ucalgary.ca/paediatrics_gastroenterology/gastroenterology-services/pgme
An elective in Paediatric GI includes the following experiences: 1.
Inpatient Wards:
As a Paediatric resident, you will be expected to perform initial consults and follow up on patients under our care. The most senior trainee on the ward rotation is in charge of carrying the “service� pager, managing the GI team, delegating consults, and ensuring all patients have been adequately followed up. Most of the time, a GI fellow will be in charge, however if there is no fellow on service, the Paediatric resident may take this responsibility. 2.
Outpatient GI clinic:
You will be booked into approximately 2 weeks of clinics if your rotation is 4 weeks in length, and 1 week of clinics if your rotation is 3 weeks or less. Clinics occur on Mondays to Thursdays and are full day clinics. Our administrative assistant will distribute this schedule to you beforehand so you are aware of the expectation. Extra patients are booked when residents attend clinic, so it is imperative that you attend all scheduled clinics. 3.
Endoscopy and Procedures:
You are invited to observe endoscopy and other procedures in the Operating Room or the GI lab. Over the course of the elective, you may be exposed to gastroscopy, colonoscopy, therapeutic endoscopy and motility studies. 4.
End of Rotation Presentation:
You are asked to prepare a small 20 minute presentation during academic half day near the end of your rotation. The topic is your choice, but it is best to choose a small, focused question that you may have encountered during your time on our service. If you have difficulties choosing a topic, the fellows and staff physicians are happy to discuss options. 5.
Teaching:
On Fridays from 8am to 12 pm, the GI Division has academic half day teaching. These mandatory teaching rounds are on a wide variety of topics and you will be notified of the schedule via email each week. You are encouraged to read about the topics beforehand to enhance your learning experience. 6.
Call:
You are not required to perform call, however if this interests you, please discuss it with the fellow or physician on call as this can be accommodated. 7.
Objectives and Goals:
Over the course of your rotation, the GI Division will familiarize you with common and some uncommon gastrointestinal, liver, nutritional, and metabolic diseases that occur in the Paediatric patient. Please refer to the objectives for the GI rotation.
8.
Research:
Residents wishing to perform small clinical projects or prepare a case report for publication should not hesitate to approach a staff to discuss potential opportunities. Such projects could be performed throughout the year and need not be limited to the period of the rotation. 9.
Evaluation:
Our division is committed to providing you a timely evaluation. Two to three days before your last day of the rotation, please ask your preceptor if you can establish a time to review your evaluation. It is critical that you: 1) notify the physician that you are ending the rotation and set an appointment to discuss your evaluation 2) provide your preceptor with an evaluation (or on-line) form. The preceptor should also provide you with interim feedback. If s/he does not discuss a mid-way assessment, please ask for feedback. 10. Contact: Ms. Pamela White - Program Administrator Paediatric Gastroenterology pamela.white@albertahealthservices.ca (403) 955-7301
Paediatric Gastroenterology Subspecialty Training Program Program Director Dr. Leanna McKenzie Alberta Children's Hospital 2888 Shaganappi Trail NW Calgary AB T3B 6A8 Phone: (403) 955-7721 Fax: (403) 955-2922 e-mail: leanna.mckenzie@albertahealthservices.ca
Program Administrator: Ms. Pamela White
For further information see also: Department of Paediatrics Main site: http://www.ucalgary.ca/paed/
http://www.calgaryhealthregion.ca/clin/child/paed
Department of Paediatrics Education page: http://www.ucalgary.ca/paed/education
Canadian Resident Matching Service (CaRMS) http://www.carms.ca
Phone: (403) 955-7301 e-mail: pamela.white@albertahealthservices.ca
The Paediatric Gastroenterology Training Program at Alberta Children’s Hospital is one of Canada’s longest established training programs in the specialty. Successful graduates have secured academic positions throughout Canada and worldwide. The section Paediatric Gastroenterology and Nutrition at Alberta Children’s Hospital offers two types of subspecialty residencies: A three year academic/research residency OR A two year clinical residency. Those who intend to pursue a career in academic paediatric gastroenterology are encouraged to complete a three year residency, which incorporates completion of a Master’s degree or
Those who intend to pursue a career in academic paediatric gastroenterology are encouraged to complete a three year residency, which incorporates completion of a Master’s degree or complete similar clinical training with a smaller research project, but do not complete a Master’s degree.
Year 1 During the first year, the major emphasis is on General Paediatric Gastroenterology and attaining endoscopy skills. The following is an example of a typical schedule for a first year subspecialty resident in our program (each block equals 4 weeks): 6 blocks Inpatient Paediatric Gastroenterology, Consultation Service and Endoscopy 4 blocks Outpatient Paediatric Gastroenterology, Endoscopy and Research 1 block Research Methods Course or Elective 1 blocks Paediatric Nutrition and Intestinal Rehabilitation Rotation 1 block Vacation Year 2/3 In year 2 a typical schedule would be as follows: 4-5 blocks Inpatient Paediatric Gastroenterology, Consultation Service and Endoscopy 5 blocks Outpatient PaediatricGastroenterology, Endoscopy and Research or Electives 1-2 blocksPaediatricHepatology/Transplantation 1 block Adult endoscopy 1 block Vacation A resident enrolled in a 3 year residency would have approximately the same clinical requirements as those in a 2 year program, but clinical activity would be distributed over 3 years, to allow for scholarly work such as research or Master’s studies. The subspecialty program in Paediatric Gastroenterology at the University of Calgary aims to individualize each trainee’s program according to their background and career goals, while maintaining standards and the requirements outlined by the Royal College of Physicians and Surgeons of Canada. Seminars and Rounds The section of Paediatric Gastroenterology is committed to residency education. Residents and staff attend and participate a 4 hour Academic Half Day (AHD) every Friday morning. AHD includes journal club, liver transplantation rounds, radiology rounds, pathology rounds, single topic sessions, research presentations, and case presentations. In addition, residents are encouraged to attend Paediatric Grand Rounds (weekly), CAG rounds (monthly) and relevant rounds within the Adult Gastroenterology training program or other subspecialties.
Electives Residents are encouraged to pursue electives depending on their learning needs and academic interests. These electives may be within Calgary or at other institutions. Electives are arranged by the resident with the aid of the Program Director during the Outpatient blocks. Examples of elective rotations include Viral Hepatology, Pathology, Metabolics, and Nutrition/Intestinal Failure. Procedures for Residency Electives - Canadian Residents Residents who are enrolled in training programs accredited by the RCPSC or CFPC can apply for electives at the University of Calgary as follows: About 4-6 months before the desired start date the resident sends to the Program Director: 1. A letter requesting the elective 2. A complete CV 3. A letter from their home Program Director in support of the elective At least 2 months before the start date of the elective, the Residency Training Program (in Calgary) sends to the PGME office the following documents: 1. A letter from the Program Director outlining: the length and kind of elective the PGY level of the trainee who will supervise the trainee 2. The PGME Registration form completed by the trainee 3. A letter from the resident’s home program in support of the elective The PGME office will send to the trainee: 1. A cover letter outlining further instructions regarding: Alberta Health Services – Medical Education Office (AHS-MEO) requirements to grant clinical access College of Physicians and Surgeons of Alberta (CPSA) registration procedures 2. A Letter of Engagement (LOE) that the trainee must sign and return to the PGME office A non-refundable administration fee of $50.00 in the form of cheque or money order payable to the University of Calgary must be sent to the UofC PGME office by the resident prior to the commencement of the elective.
Electives Continued. The PGME office will inform both AHS-MEO and the CPSA of the upcoming elective. Their respective registration processes may take up to two months to complete, so the trainee should not delay starting the application. TRAINEES ARE NOT ALLOWED TO HAVE ANY CONTACT WITH PATIENTS UNLESS THEY ARE LICENSED BY THE COLLEGE OF PHYSICIANS AND SURGEONS OF ALBERTA (www.cpsa.ab.ca) ALL TRAINEES MUST BE COVERED BY THE CANADIAN MEDICAL PROTECTIVE ASSOCIATION (www.cmpa-acpm.ca) Vacation and Call Vacation Residents receive four weeks of holiday each year, which can be taken together, or divided into shorter periods. Residents are responsible for creating their own call and service schedule as a group. Call Call is taken from home and is 1 in 4 weeknights and weekends throughout the year. Residents create their own call schedule, which must comply with PARA guidelines. Residents' Clinic Beginning in the 1st year of the program, residents participate in a half day longitudinal follow-up clinic under the supervision of one of the attending paediatric gastroenterologists. Residents continue to follow these patients through this clinic throughout their training. Research During the first year, residents are given the opportunity to take part in a 4-week Research methods Course, which enables them to establish a clinical or basic science research project to be completed during their training. The Research Director for our section also meets with residents to provide ideas and mentorship for research projects. Funding is available through PGME to allow residents to present their results at a national or international scientific meeting. Selection Criteria and Funding Selection Criteria Entrance into the Paediatric Gastroenterology program is through the Canadian Resident Matching Service (CaRMS), subspecialty match. Paediatric residents may enter subspecialty training after either their third or fourth year of General Paediatrics. Qualifying candidates should demonstrate a strong academic record, excellent communication skills, and enjoy technical procedures. Research experience is an asset. Funding Successful CaRMS candidates receive two years of guaranteed funding, regardless of their level of Paediatrics training completed (PGY 3 or 4). Those wish to complete a third year of fellowship apply for competitive research funding through Alberta Children’s Hospital Research Institute (ACHRI). Please note that currently, our fellowship does not have funding for international trainees to pursue a clinical fellowship. International trainees interested in a research fellowship may apply for competitive research funding through ACHRI, if selected by the Program Director. Applicants with their own funding through their home country may apply directly to the Program Director, with the exception of those from Saudi Arabia, who must apply through the Embassy.
Alberta Children's Hospital 2888 Shaganappi Trail NW Calgary, Alberta T3B 6A8 Canada Phone: 403-955-7211
Gastroenterology Clinic The Gastroenterology Clinic is located on the 3rd Floor. From the main elevators, exit left. Turn left at the main hallway and follow the signs down the hall. Phone: 403-955-7747. Fax: 403-955-7639. GI Lab The GI Lab is located on the 3rd floor. From the main elevators, exit left. Turn right at the main hallway and follow the signs down the hall. The GI Lab will be on your left hand side. Phone: 403-955-7286. Day Surgery (Endoscopic procedures) Day Surgery is located on 3rd Floor. From the main elevators, exit left. Turn right at the main hallway and follow the signs down the hall. Day Surgery will be on your right hand side. Phone: 403-955-7855.
Department of Paediatrics