Primary Contact Spring 2021 by Canadian Memorial Chiropractic College

PRIMARY CONTACT

SPRING 2021

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Volume 59

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Issue No. 2

Innovating for the Future

A publication from the Canadian Memorial Chiropractic College for alumni, members and friends

www.cmcc.ca

WHAT’S NEW @ THE SUPPLY CENTRE

The perfect gifts for family, friends & loved ones.

INTRODUCING BACH BONE The Bach Bone is a line of prenatal cushions designed to increase comfort for patients and practitioners. Improve and expand your practice today by including comfortable, accessible and effective prenatal care options for your community. You can purchase and learn more about the Bach Bone at the Supply Centre website.

Supply Centre and Bookstore 1 800 268 8940

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IN THIS ISSUE 02

From the President

From the Chair

How did we pivot the second time?

Alumni News CMCC News

CMCC celebrates together!

CMCC expands its externship program

Photos from Cooking with Chef Carolyn

Ensuring the growth of research and academic strength

CMCC congratulates Dr. John DeFinney

The right pair of eyes can save the day

CMCC Donor Update

In Memoriam

Passages

Donations

Practice OpportUnity ‘21

Go green: You can reduce your carbon footprint and read Primary Contact in a digital format (PDF) instead of receiving a paper copy. Email us at communications@cmcc.ca and we’ll make the switch for you.

Primary Contact - Spring 2021

FROM THE PRESIDENT

A YEAR OF REFLECTION

Simply put, this last year will certainly never be forgotten. Every

member of our extended CMCC community has been affected by the COVID-19 pandemic. From practices that were shuttered as restrictions were imposed, to losses of loved ones, cancellation of association meetings, inability to visit friends and family members, holiday plans scrapped, favourite restaurants closed down, trying to deliver telehealth services, parents and students learning how to navigate through working and learning at home – and the list goes on. When I wrote you six months ago about how CMCC was forced to pivot to the virtual learning environment in March of 2020, we certainly did not think we would still be in that position in 2021.

Our students have been understanding, flexible, resilient and dedicated to their studies. Despite the pressures of the pandemic, not a single student failed to return after the summer recess and resume their studies in August 2020. Similarly, the new student class was completely full, and we had our usual wait list of qualified applicants. This speaks volumes to the appeal of the chiropractic profession and of the reputation of CMCC. Unfortunately, we also lost many opportunities to gather our friends and alumni for special events. Convocation in June 2020 became a virtual event instead of our usual joyous celebration at Roy Thomson

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Hall in Toronto. As I write this, it appears that this will also be the case for the Class of 2021 because the city has cancelled all gatherings at least until July and there will likely be restrictions on large gatherings everywhere in Ontario for many months to come. We converted our annual Backs In Motion fundraising run/walk to a virtual event last year and will have to do so again this year. Our 75th anniversary gala and Homecoming event that was to have been held last June at the Royal Ontario Museum was canceled and the replacement event for this coming June will be a virtual event. We can’t even predict if the August 2021 term will be able to be opened on campus or if we will have to start in the virtual setting. Through all this, our employees, students and Board members have remained solidly supportive of CMCC and appreciative of all we have done to ensure the safety of everyone on campus. Just think back about your time in the Leslie or Bayview classrooms and lecture halls, and now imagine chiropractic technique tables spread out over the gymnasium, the CCPA hall, and every available space. Think about all lectures and small group sessions being delivered online and taking tests at home while a faculty member provides remote proctoring via a video link. Imagine the stories our students will be able to tell when they reminisce about their experience at CMCC this past year. Through all of this we have learned many valuable lessons. The hallmark of a great institution is not its perception of being the best, but rather its willingness to reflect on its actions, identify weaknesses, flaws and places to improve, and then implement changes to make

those needed improvements. We learned that some of the changes we made in delivery of our curriculum during the pandemic were actually better that our time-honoured methods of the past. We learned that we could provide much greater flexibility to employee working hours and locations than we would have considered previously. We became more appreciative of the need to provide supports to help employees and students to cope with stress and mental health challenges. This past year has also been spent on an intense time of reflection on our institution and the Doctor of Chiropractic degree program over the past decade. As I mentioned to you last year, we submitted an application to the CCE-US for becoming accredited by that organization. Because we were also approaching renewal cycles for accreditation by CCE-Canada (CCEC) and for our degree granting consent from the Ministry, we had to juggle these three major reviews to build upon each other. We asked the Ministry, and were approved, to extend our approval period by two years so that we could use our CCEC self-study in our application materials. We asked CCEC, and were approved, to advance our renewal by one year for the same reason. We will have site team visits by both the CCE-US and CCEC this year, and the Ministry is coordinating with the latter to add a ministerial observer to the CCEC team. By the time you read this, we will have submitted separate self-study reports to the two CCE agencies, describing in detail how our program operates, how we measure student learning outcomes and clinical competencies, and areas we have identified for improvement. The two accrediting agencies share some of the same requirements, but each has its own areas of focus and

interest. The Ministry has additional requirements and interests. All of this adds up to a huge undertaking by CMCC, but the underlying purpose and outcome is to have external experts on education, accreditation, institutional operations, patient care, research, student supports, learning resources, the chiropractic profession and many other areas evaluate our performance, validate our self-studies, and make recommendations for improvement. Each of you, in your own way, has contributed to the strength and success of CMCC. You provided feedback to us when you were students and have since participated in alumni surveys. You have generously donated to CMCC, helping to keep our tuition level among the lowest in North America and providing financial awards to our students. You’ve renewed your CMCC Membership and rejoined the Governors’ Club. By the way, since its inception in 1981, the Governors’ Club has contributed over $2,250,000 to CMCC! You’ve attended Homecomings and alumni events over the years. You’ve met with me at gatherings across Canada. We’ve learned much from you and for this, as well as your continuing philanthropic support, we are grateful. This will be a year to remember, but I want the memories not to be about the pandemic, but rather about how great our institution is and our determination to become even better.

David Wickes, DC, MA

Primary Contact - Spring 2021

FROM THE CHAIR their success throughout these most challenging times.

Hello dear colleagues and friends. It is with great pleasure and humility that I am able to connect with you once again through this message. I hope that everything is going well for you and your precious ones and that life continues to bring you moments of joy every day despite this pandemic which has changed our daily lives for over a year now. Through health measures imposed by governments and to ensure a safe and healthy environment for our students and the entire CMCC community, we have had to face significant challenges both at the organizational and financial levels. Every member of our great institution, under the leadership of our President Dr. Wickes, has worked tirelessly and with exceptional commitment so that our students, the future of our profession, could continue to receive an education of the highest quality and pursue their journey to success both academically and professionally. I congratulate our students who have demonstrated remarkable resilience and unparalleled commitment to ensure

The year 2021 will be very busy at CMCC even if most of the activities will be virtual. The new ways of doing things require meticulous work and great creativity on the part of CMCC employees. Their organizational success never ceases to amaze us. Practice OpportUnity on February 17 was a most striking example with over 650 participants including students, sponsors, associations, vendors and chiropractors from Canada, the USA and the Caribbean. Some members of the Board of Governors participated and witnessed this huge success while interacting with students. 2021 will also be a pivotal one for CMCC because self-study documents are required by our accreditation agencies, both chiropractic and governmental. Moreover, for the first time, CMCC is seeking accreditation by the CCEUS to expand practice prospects for our students. Preparing for these self-studies requires a tremendous amount of work and I congratulate the entire team for this truly remarkable commitment. I also thank all members of the Board of Governors for providing their invaluable feedback in the development of these documents. Backs in Motion will be held virtually in May. We are counting on your indispensable support again this year to make this event a huge success. The weekend of June 3-5 will be one of great celebration as we virtually welcome you to an unforgettable Homecoming with high quality continuing education sessions, all crowned with a huge

party to celebrate CMCC’s 75th anniversary. I encourage you to join us during this extraordinary celebration of chiropractic and friendship. It is through the commitment of each member of the CMCC family, of which you are a part, that we can succeed in our mission: deliver world class chiropractic education, research and patient care. Again thank you very much for your unconditional and constant support. On behalf of all of us at CMCC, I convey my deepest sympathies to all those who have suffered the heavy loss of a family member or friend in this time where nothing is really normal. Stay safe and healthy

Bonjour chers/ères collègues et amis/es, c'est avec un énorme privilège que je profite de cette opportunité de communiquer à nouveau avec vous. Je souhaite que tout se passe très bien pour vous et vos êtres précieux et que la vie vous apporte chaque jour des moments de grands bonheurs à travers cette pandémie qui a bouleversé notre quotidien depuis déjà plus d’un an. Les mesures de santé et d’hygiène imposées par les gouvernements afin d'assurer un environnement sécuritaire à nos étudiants et à l'ensemble de la communauté du CMCC nous ont amené à faire face à des défis très importants, tant sur le plan organisationnel que financier. Chaque membre de notre grande institution sous le leadership de notre président Dr Wickes a travaillé sans relâche et

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“It’s your reaction to adversity, not adversity itself that determines how your life’s story will develop.” Uchtdorf

avec un engagement exceptionnel afin que nos étudiants, l'avenir de notre profession, puissent continuer à recevoir une éducation de la plus haute qualité et poursuivre leur chemin vers la réussite tant sur le plan académique que professionnel. Je félicite tous nos étudiants qui ont fait su faire preuve d'une résilience exceptionnelle et d'un engagement sans égal. L'année 2021 sera des plus occupée au CMCC et ce même si la plupart des activités prévues le seront de façon virtuelle. Ces nouvelles façons de faire exigent un travail minutieux et une grande créativité de la part de tous les employés du CMCC. Les succès obtenus à chaque événement ne cessent de nous émerveiller. L’activité « Practice OpportUnity » qui a eu lieu le 17 février dernier en est un exemple des plus frappants alors que plus de 650 participants y ont assisté provenant du Canada, des États-Unis et des Caraïbes. Des membres du « Board of Governors » qui étaient présents lors de l'événement afin d’interagir avec les participants ont pu être témoins de cet énorme succès. 2021 sera aussi une année charnière pour notre CMCC, car nous devrons présenter un document imposant aux

différentes agences d'accréditation autant chiropratiques que gouvernementales. D'ailleurs, pour la première fois, une demande d'accréditation sera faite au CCEUS afin d’élargir les perspectives de pratique pour nos étudiants. La préparation de cet ouvrage nécessite une charge de travail gigantesque et je félicite toute l'équipe du Dr Wickes pour ce dévouement tout à fait remarquable. Je remercie également tous les membres du «Board of Governors» qui ont apporté leur contribution inestimable à l'élaboration de ce document. L'événement « Backs in Motion » se tiendra de façon virtuelle en mai. Nous comptons sur votre support essentiel encore cette année afin de faire de cet événement un énorme succès. Une grande fête virtuelle sera présentée du 3 au 5 juin alors que nous vous accueillerons lors d'un « Homecoming » des plus inoubliables, de formations d'éducation continue de très haute qualité le tout couronné d'une grande fête afin de célébrer le 75ème anniversaire du CMCC. Je vous invite donc à vous joindre à nous pour cette extraordinaire célébration chiropratique et d'amitié. C'est à travers un engagement exceptionnel de chacun

des membres de la grande famille du CMCC, dont vous faites partie, que nous pouvons réussir à remplir cette grande mission de procurer un enseignement et un programme de recherche de renommée mondiale ainsi qu'un service et des soins exceptionnels à tous nos patients qui nous accordent leur confiance. Merci encore énormément de votre support inconditionnel et constant des plus précieux en cette période remplie d’innombrables défis. Pour terminer, je désire au nom de tous les membres de la famille du CMCC, transmettre mes souhaits de profondes sympathies à tous ceux et celles qui ont subi la lourde perte d'un membre de la famille ou d’un ami en cette période où rien n'est jamais vraiment normal.

Richard Mercier, DC To contact any member of the Board, please email board@cmcc.ca.

Primary Contact - Spring 2021

HOW DID WE PIVOT THE SECOND TIME? DEALING WITH ONTARIO’S SECOND WAVE

Following a successful pivot that allowed CMCC students to stay on course through the year-long restriction on class sizes beginning in March 2020, and which saw us pivot to an almost completely virtual program, CMCC administration received a surprise email at 5:30 p.m. on Sunday, November 22, further reducing the acceptable group size per instructional space to 10, beginning on Monday, November 23, 2020. Through foresight and preparation, CMCC was able to quickly pivot again. Dr. Dominic Giuliano (Class

of ‘92), Acting Director, Experiential Learning, was responsible for engineering the quick response. “I had been thinking of three potential scenarios, the ugliest of which was dropping the numbers to just 9 students and a tutor.” We only have 12 technique rooms, so this required a double up on sessions and pulling tutors in from other areas. With this notice, we had to move even more quickly and even extend our recruiting of tutors externally. That first week, we were still recruiting but by the following week (30th) we were set with our groups of 10, everyone still in the

social bubbles with which they started the year. Before moving into the December holidays, Giuliano created contingency plans for several scenarios, including the possibility of a complete pause in in-person labs. Not knowing if in-person exams would be possible, he and Dr. Dave Starmer (Director, Year III) ran trials of virtual testing environments. Should it be necessary, Starmer had already shown the student groups where they would be writing so there would be no surprises come exam time.

Alumni www.cmcc.ca

News

THE CLASS OF 2020 LEGACY AWARD The extraordinary events of the past year made it impossible for the Class of 2020 to celebrate their graduation or enjoy the traditional trip used to celebrate their accomplishments and solidify their bond as a cohort of new chiropractors. After managing the disruption to their final weeks at CMCC, class members reflected on the challenges they experienced and decided to use their graduation fund to honour future students who have in turn, overcome personal challenges through perseverance.

The generous donation will fund an award in perpetuity.

efforts in art, science and business or for working for Danish interests.

JAN HARTVIGSEN, ADJUNCT PROFESSOR CMCC, WAS RECENTLY APPOINTED KNIGHT OF DANNEBROG BY HER MAJESTY QUEEN MARGRETHE II OF DENMARK

Jan Hartvigsen is one of the world’s leading researchers in pain and disease in muscles and joints with a focus on the spine and was a leading researcher behind a landmark report on back pain, which was published in the prestigious journal The Lancet.

From the European Chiropractors Union: The Knight’s Cross can be awarded to Danes and foreigners for meritorious civil or military service, for special

European Chiropractors Union (December 21, 2020) ECU Congratulates Jan Hartvigsen https://www.chiropractic-ecu.org/ ecu-congratulates-jan-hartvigsen/

CMCC NEWS NEW STUDENT INFORMATION SYSTEM In December 2020, CMCC began the phased implementation of a new Student Information System (SIS), CampusNexus Student (CNS). The need for better functionality and integration, along with Blackbaud’s announcement that they would end support for Education Edge, the system used for the last 10 years. The IT and Student Services divisions entertained Requests for Proposals from SIS vendors. After a comprehensive search, CampusNexus Student by Anthology was selected for its modular, webbased platform and integration with other campus systems including Canvas, CMCC's Learning Management System. After a year-long configuration and data conversion process, CampusNexus Student was rolled out in December 2020 to Student

Services and Accounting division staff for the daily management of all admissions and registration information for students. In the coming months, CNS will be further expanded to staff in other areas including Undergraduate Education and Graduate Studies. A student portal, where students can update their records, access their registration, billing and grades information, make records requests and online payments will also be implemented in the coming months. The new system will allow for more comprehensive admissionslead management, a shift to digital record keeping, improved collaboration between departments and better access to information for students. PowerBI integration will provide new opportunities for data collection and analysis.

Thank you to the Student Services, Finance and most importantly, Information Technology staff for their dedication to this project and congratulations on a successful implementation.

EQUITY, DIVERSITY AND INCLUSION CMCC announced the formation of an Equity, Diversity and Inclusion (EDI) Committee in September 2019. The committee, represented by co-chairs Jacquelyn Wingrove and Sharanya Varatharajan will serve as a forum to support the community at CMCC where students, staff, and faculty feel acknowledged, respected and a sense of belonging. The committee’s role includes the development of recommendations to ensure CMCC maintains an environment free of discrimination and intolerance.

Primary Contact - Spring 2021

CMCC CELEBRATES TOGETHER! June 3-5, 2021 Homecoming is going virtual…help us make this a truly global event! Time to set aside the challenges of the past year and come together for a celebration like no other! Traditionally, Homecoming represents a unique opportunity to schedule some personal time and meet with classmates, alumni and other chiropractors. This year, we are celebrating our anniversary classes and so much more as we are combining Homecoming 2020 and 2021 with a celebration of CMCC’s milestone 75th anniversary.

Participate in the annual Anniversary Awards by nominating and recognizing your peers for their contributions to the profession and their local communities. The categories are Alumnus/a of the Year, Community Service Award and Pioneer Award. More details to come.

For more information including a list of anniversary classes, please visit our event page at www.cmcc.ca/cmcc75 or contact events@ cmcc.ca or 647 265 4186 8

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There are so many other great reasons to attend and you don’t have to be a CMCC grad to participate! • Reunite with your classmates from around the world in the comfort of your home or office…our virtual platform will allow you to see and engage with each other • Join us at our amazing Gala for exciting awards presentations, anniversary class recognition, musical entertainment and so much more • Need a break from CE or meeting with classmates? …look no further than a variety of fun, family friendly activities • Our online auction will have several great items on display which can be shipped to you regardless of where you live

Three days and three streams of Continuing Education! Pain Management, Rehabilitation and Interprofessional Communications • Over 25 leading chiropractic experts. • Come hear Dr. Michael Schneider on The Future of Chronic Low Back Pain Research and Clinical Management and Dr. Jason Busse on Acute and Chronic Pain: Opioids and Cannabis vs. Alternatives. • Also featured in the program are practical workshops including: - Evidence-Based Approach to Chiropractic Care for the Pregnant and Postpartum Patient: Drs. Carol Ann Weis and Crystal Draper - Extremity and Spinal Adjusting of the Hip, Shoulder and Lumbar Spine: Dr. Mohsen Kazemi - Exercises for Hip and Knee Osteoarthritis from the GLA:D Initiative: Dr. Craig Jacobs - Biopsychosocial Strategies in Clinical Case Management: Dr. Matthew Barrigar

Primary Contact - Spring 2021

CMCC EXPANDS ITS EXTERNSHIP PROGRAM

Left to right: Dr. Kevin Roberge, Interns Lauren Boilard and Brad McGarr and Dr. Michelle Laframboise

Every year, CMCC sends a number of interns into the field to work under the supervision of a chiropractor in private practice. In doing so, students are able to work in their home province or try an opportunity elsewhere. Typically, a handful of interns take advantage of the opportunity towards the end of their graduating year. Beginning in 2020, as the pandemic enforced limits on in-person clinical experiences at one of CMCC’s community clinics, we took the opportunity to expand our externship program. Reaching out into our community of alumni and through student-initiated opportunities, we launched the program earlier in the year, allowing interns who have demonstrated their proficiency to undertake more of these experiences. The

program has opened up space within the CMCC clinic system for the remaining interns to take on additional patients within our community clinics as well as providing new opportunities for students and practicing chiropractors. Lauren Boilard at Cranbrook Chiropractic with Dr. Kevin Roberge Dr. Kevin Roberge (Class of ‘00), practices in Cranbrook, BC. In November, 2020, he welcomed Lauren Boilard as an extern in his clinic, Cranbrook Chiropractic & Wellness Centre. Boilard had shadowed Roberge before entering CMCC and returned during summers, becoming familiar with the practice. In her final year, as COVID began to change CMCC’s clinical program, Boilard was

welcomed to Roberge’s practice for an early externship. “The interpersonal fit between the extern or an associate and the clinician is one of the most important things. Everything else is teachable or will come with experience. She gelled with the rest of the clinic staff as well, so it was an easy decision to have her come in five months early in November as opposed to March,” says Roberge. He knew the practice was busy enough to provide her with the experience she needed. An additional consideration during the pandemic was space, so Roberge cleared another office area, and was ready when she arrived home to Cranbrook. “Lauren has been learning our

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office systems over the summers, so it has been an easy transition for us,” says Roberge. “In addition, she also has a clinician at CMCC for support and guidance. For me, learning to articulate what has become second nature, like the nuances of an adjustment has been rewarding.” It has worked out so well that Boilard has been asked to stay on at the practice following graduation. Boilard explained that she connected with several chiropractors, starting as early as first year, seeking shadowing experiences. Roberge’s practice style, personality and the clinic environment were a natural fit from the beginning. “Get out as early as you can,” is her advice to students. “I was one of the first ones in my class shadowing so early. It gave me an early start to my externship. It may mean giving up time spent with family to cold call, visit practices, but it will pay off in the end. I am so grateful for this opportunity with Dr. Roberge and that it has turned out even better than I could’ve imagined; the staff have also been so warm and welcoming as well.” For Boilard, it meant a busy externship in which she is getting a lot of varied patient experiences. “It definitely grows your independence.” Brad McGarr with Dr. Michelle Laframboise at Orillia Sports Medicine In Ontario, Brad McGarr has been an extern with Dr. Michelle Laframboise at Orillia Sports Medicine, a multidisciplinary rehabilitation-focussed facility. Like

"It’s a very progressive CMCC program and puts interns in the right position” Dr. Michelle Laframboise

Roberge, Laframboise had a history with McGarr, he having shown an interest in her clinic early on, and having shadowed her for the past two years. “He is a huge asset to the clinic, with amazing skills,” says Laframboise, a Fellow with the Royal College of Chiropractic Sports Sciences (Canada). As a strengthening and conditioning coach in Toronto, McGarr’s interests and experience were a great match for the clinic. As a sports resident at CMCC, Laframboise already had experience as a clinician at CMCC and had hosted a successful externship at her practice in 2020. “It’s a very progressive CMCC program and puts interns in the right position,” says Laframboise. McGarr approached Laframboise in 2018, honing in on a clinical experience that would support his interests in sports chiropractic. His cousin Mike McGarr, also a chiropractor, told him about the rehabilitation-focussed clinic. “Its amazing,” says McGarr. “It’s everything I want – a 12,000 sq ft performance centre with an active rehabilitation focus. It reflects the way I want to treat. I‘ve been a strength and conditioning coach for four to five years now. I really enjoy

taking patients to the gym and doing active care and rehabilitation. Within this internship, I am able to treat in this way.” In terms of advice for anyone considering an externship, McGarr says “get out of the bubble and shadow as soon as possible," adding that he has learned so much through this experience. “He was prepared well and was ready,” says Laframboise. "If anyone is considering offering an externship, it’s a great learning experience for the entire clinic. If you are open minded as a clinician, you can learn a lot from these amazing interns. It can be such a good partnership, with learning on both sides. He has learning objectives from CMCC which he shares with the entire clinic. Next week, for example, he is presenting on Shockwave. It’s really a terrific experience.” Laframboise adds that having an extern like McGarr has increased the energy in the clinic through his zest for treating patients and the questions he asks. “You can actually forget about the pandemic once in a while!” For additional information on how you can get involved in this important and advantageous program, please email Jacquelyn Wingrove at jawingrove@cmcc.ca.

Primary Contact - Spring 2021

NOVEMBER 4, CMCC HOSTED A VIRTUAL COOKING CLASS WITH CHEF CAROLYN Thank you to everyone who registered for CMCC’s 90-minute virtual gourmet cooking class sponsored by Penmore Financial. We were so excited to be cooking along with Chef Carolyn, owner of Delicious Dish, on Wednesday, November 4! The menu: • Jeweled cauliflower couscous with quinoa and pomegranate • Boneless turkey breast with tomato, white wine and garlic • Rustic apple and pear galette • Apple cider. All those who registered received: the menu, recipes, grocery list, recommended cooking tools, preparation instructions, Zoom link, and the recording of the class. Chef Carolyn also made recipe substitutions for those who were gluten free and for those who didn’t have all the tools needed for some of the recipes – making the class a piece of cake! Overall we had 56 people register, 28 attend the live event and we raised $750! All proceeds raised go to supporting CMCC’s operational expenses, such as Personal Protective Equipment (PPE) costs for clinics and hands-on labs!

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PRACTICE OPPORTUNITY ‘21

In association with the Ontario Chiropractic Association

On Wednesday, February 17, 2021, CMCC hosted our first virtual Practice OpportUnity Day. We were astounded to welcome 663 participants, including 500 attendees! Each year, we bring together CMCC students, faculty, chiropractors and industry vendors for this popular event. This year, we were able to bring the conference to an even wider audience as we went virtual! We searched far and wide for an event platform that would live up to the expectations of this signature event and chose vFairs, a widely-accessible, versatile event platform. We were very pleased with the successful turnout and number of job applications that were facilitated – 178 jobs were applied for via the online “apply now” function at the virtual booths. We welcomed 54 chiropractors from across Canada and two international attendees from the US and Carribean.

All together, we had 12 vendors, eight associations and six sponsors. Our title sponsor, the Ontario Chiropractic Association (OCA), brought us the Practice Realities Panel, moderated by Dr. Moez Rajwani in which established chiropractors Drs. Nardine Bekhit, Angelica Mazzella and Patrick Welsh described their experiences starting out. Following the OCA webinar was our Keynote Address webinar sponsored by the Canadian Chiropractic Association and presented by Dr. Steven Passmore and Dr. Gerald Olin – who brought everyone on an excellent adventure through their chiropractic careers! At the conclusion of the webinars, our two virtual halls opened: Exhibit Hall, which hosted the sponsors, vendors, and associations, and our Chiropractic Hall, which offered upcoming opportunities for our students. Multiple vendors told us that they enjoyed the convenience of the

conference and appreciated the easy access to other vendors and participants, particularly those they would not have been able to connect with, had travel been necessary. There was an additional benefit to the virtual environment in that registrants are able to revisit the conference until early May. Thank you to each of our sponsors, vendors, chiropractors, and attendees for your patience and support as we adapted to the new virtual event platform. Special thank you to our sponsors who stuck with us this year and the new ones who joined us: Title Sponsor: Ontario Chiropractic Association Keynote Sponsor: Canadian Chiropractic Association Silver Sponsors: Divine Spine, Massage Addict, MyRemoteClinic Bronze Sponsor: Alberta College and Association of Chiropractors

Primary Contact - Spring 2021

ENSURING THE GROWTH OF RESEARCH AND ACADEMIC STRENGTH: CMCC’S JOURNEY INTO RESEARCH AND THE DEVELOPMENT OF THE CLINICAL SCIENCES RESIDENCY PROGRAM eye, while medicine had moved forward from its own vitalistic days towards modern bioscientific research-based treatments.

Dr. Adrian Grice (Circa 1980)

In the early 70s, chiropractic was a bit of an island - isolated professionally while internally, it remained divided between mixers and purists who adhered to spinal-pelvic manipulative therapy, often following systems practitioners (see page19). Research was still a twinkle in chiropractic’s

In the early-mid 60s, Drs. Lyman Johnston (Class of ’60) and David Drum (Class of ’67), wrote papers on posture for the Journal of the Canadian Chiropractic Association (JCCA), which was, at that time, not yet the important, peer-reviewed journal it evolved to be. In 1970, Dr. Adrian Grice (Class of ’59) wrote on the biomechanics and kinesiology of posture. These were amongst the few papers in the journal that attempted scientific analysis. The question of chiropractic’s role in the health care landscape began to take shape as it was becoming clear that demonstrating the science behind chiropractic was essential to moving forward. There were pressures that were to come from the Ontario medical profession, a governmental inquiry, and the

opportunity for inclusion in provincial medicare systems. In order to develop the science of chiropractic, Drs. Ron Gitelman (Class of ’61), the Head of CMCC’s Orthopaedics Department, Adrian Grice, the Head of the Chiropractic Science Department, and Robert J Johnston (Class of ‘60), the Head of the Clinical Science Department, began to conceive of a way to encourage scholarship and leadership within chiropractic. Together, Gitelman, Grice and Drum built lectures from the growing body of literature from which Gitelman was also developing archives. Johnston reviewed the models for medical fellowships and from that, designed the format and curriculum for what would become the Fellowship of Chiropractic Clinical Science. Drum, an artist, was also enlisted by CMCC to draw anatomical representations as he did for medical texts. (An accomplished artist, some of his work

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Dr. Scott Haldeman (Palmer, Class of ’64), and a current CMCC Board of Governors Member, recalls that particular time in CMCC’s history in 1970 when he was briefly on faculty teaching neurophysiology while writing his Canadian licensure examinations and was asked to investigate a device called the SynchroTherme. This fascinating device was said to “provide valid insight into the function of the autonomic regulation of spinal blood flow and was purported to determine the location of spinal subluxations.” Of his time at CMCC, Haldeman says, “Many of the experienced chiropractors in Canada were graduates of US colleges, especially Palmer College and National College of Chiropractic. These colleges represented two markedly different schools of thought. Some were so-called ‘straights,’ whose practices were limited to cervical adjustments only or full-spine practitioners who offered no services other than manipulation. Others were so-called ‘mixers,’ who thought chiropractic could be extended beyond the spine to treat peripheral joint, even visceral and non-spinal disorders.

Haldeman recalls that there was a filing cabinet that was literally overflowing with research articles, some of which they hadn’t yet studied. A group of CMCC faculty began to meet weekly and discuss this literature. The members of this group had very different backgrounds and ideas representing all chiropractic perspectives. They included chiropractors who felt strongly about traditional chiropractic philosophy, purists with different practice methods, faculty with a strong scientific bent and others whose interest was developing new clinical instruments or treatment techniques. “It was a marvelous intellectual group. Fantastic,” says Haldeman. It was from this collected work that Gitelman and his colleagues developed what was later to be known as the archives (see: The Archives, see page 16). In those early days, there was major conflict between medicine and chiropractic and it was considered unethical for a medical practitioner to refer or receive referrals from a chiropractor or consider cooperation in research. Haldeman recalls being warned, as he pursued his medical degree following his licensure as a chiropractor, that he should not speak to chiropractors. After completing his national board examination and his work on the Syncro-Therme, Haldeman left for UBC where he pursued his PhD in Neurophysiology and his MD degree. He would later publish Principles and Practice of Chiropractic, the first chiropractic textbook from a medical publishing house with contributions by Gitelman and Grice based on their lectures from the Clinical Sciences Department.

can be seen in the halls, offices and library at CMCC). 1974 - 6: The launch of the Fellowship, the NINDS Conference and the first CMCC Residents In 1974, the core group of researchers, with the support of CMCC Associate Dean Tom Maxwell (Class of ’55), Dean Herb Vear (Class of ’49) and CMCC Board Chair Dr. David Churchill (Class of ’52), saw their vision fulfilled with the founding of the College of Chiropractic Sciences (CCS), the purpose of which was to ensure continued research and academic leadership within the profession. Together, CMCC and the CCS established a two-year full-time post-graduate residency program in clinical sciences to prepare graduates of the chiropractic program for the Fellowship examination and entrance into the CCS. The first resident was Dr. Michel Moscatelli (Class of ’74) followed by Dr. Don Henderson (Class of ’75). Vear, Maxwell and Churchill provided much needed endorsement, securing support from the provincial associations as well as the Canadian Chiropractic Association and CMCC’s Board of Governors. Their support

Dr. Robert J. Johnston (Circa 1975)

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was vital at this time, while members among those groups were still invested in the vitalistic principles of chiropractic. Adding to the momentum of the previous year, 1975 saw the first conference of the National Institute of Neurological Disorders and Stroke (NINDS), devoted to the mechanisms of spinal manipulation. Haldeman was a Workshop Planning Committee member and invited Gitelman and Drum to accompany him, presenting on behalf of chiropractic. With an audience of medical doctors, researchers and neurologists, the three were able to demonstrate the sophistication of nascent chiropractic research, of which many of the conference attendees were unaware. In 1976, the CMCC graduate program accepted five Residents: Dr. Mike Wiles, (Class of ‘76), presently Dean at Keiser University in West Palm Beach, Florida, was among the first CMCC residents. “In 1976 they accepted five residents into the program – myself, and Drs. Lu Barbuto, John Bare, Toffy Kobrossi, and John DeGruchy (all Class of ’76),” says Wiles. Initially, the program relied on guided independent learning. From that year on, until the 2000’s, two residents were chosen annually. An opportunity in Saskatoon, SK Gitelman’s presentation at NINDS

Left to right: Drs. Silvano Mior and Howard Vernon (1993)

had opened doors for chiropractic and facilitated the next stage of the residency program. He and Grice began the development of a project at Saskatoon’s Royal University Hospital where an orthopaedic surgeon, Dr. Kirkaldy-Willis, aka KW), had been working with CMCC graduate Dr. Gord Potter (Class of ’58). KW had trained in Cambridge and London, England, and had practiced in Kenya, where he encountered lay practitioners of manipulation. When Potter’s own practice became too busy, KW spoke to CMCC about the possibility of bringing someone else to Saskatoon to work with him. Vear asked Gitelman and Grice to

develop the opportunity, and they chose new graduate Dr. David Cassidy (Class of ’75) who agreed to move to Saskatoon for six months as a resident of the new program to learn from and work with KW in the hospital‘s busy outpatient orthopaedic clinic. Grice and Churchill convinced the CMCC Board to support the initiative and provide a $12,000 stipend for Cassidy. It was perhaps the first time the CMCC Board financially supported research and requested monthly reports by Grice to justify the expense. At the end of the six months, Cassidy elected to stay on. “The opportunity was excellent,” says Cassidy. “You saw conditions you would rarely see in a

The Archives Gitelman, responding to the need for a more systematic search process for the chiropractic literature they were amassing, set about to organize the first collection of scientific articles supporting chiropractic in 1974. Published originally as “The Archives,” the collection would later – for better or worse – be known as CRAC (Chiropractic Research Archives Collection). In 1979, new Dean Dr. Alan Adams joined CMCC and hired librarian Claire Callaghan to assist with the project and develop the library. CRAC was published in four volumes and served the profession until the advent of internet-based databases and search engines such as PubMed. Callaghan was credited for building the CMCC library into one of the best chiropractic libraries in North America. Dr. Howard Vernon (Class of ’77), later to become a Fellow of the Clinical Sciences Residency program, was a student when CRAC was first published: “The very idea that there was supportive literature that went beyond the pronouncements of our teachers was thrilling.” (Vernon, 2013)

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chiropractic clinic and could easily see 20 patients in the hospital and another 20 in the outpatient clinic afterwards.” Cassidy remained in Saskatoon, and by 1980 the idea of a clinical rotation in Saskatoon for everyone in the residency program had taken shape. Cassidy, remaining in Saskatoon, coordinated the program, freeing Grice to concentrate on leading the Division of Chiropractic Sciences through CMCC’s continuing evolution under Dean Alan Adams. “We came to realize how valuable it was for the residents to practice in a hospital where there was access to neurology, spine and general orthopaedics, the pain clinic, rheumatology, etc.,” says Cassidy. “The whole program came together and allowed the graduate students to learn in the same way that most medical residents would. As it was a university hospital, there were many serious cases and it was really good training.” Another positive was that chiropractic treatment was covered by provincial health care in Saskatchewan. The opportunities more than offset the Saskatoon winters and as Cassidy recalls, “We kept an extra parka at the hospital.”

has been instrumental in CMCC’s establishment of key research and educational partnerships. He is also Senior Scientist with the Centre for Disability Prevention and Research, and the Coordinator of the Clinical Sciences graduate program. Concurrent with work at CMCC, he was also seconded to the Ontario Ministry of Health and Long Term Care as a Senior Clinical Advisor. After Mior, Dr. Marion MacGregor (Class of ‘80) graduated from the residency program in 1984, after which she earned her Masters in Medical Epidemiology at McMaster and her PhD in Public Policy and Political Economy at the University of Texas garnering numerous honours for her work. After teaching and doing research at National Chiropractic College, the Texas Back Institute and Texas Chiropractic College, MacGregor returned to CMCC as a researcher, and Director of Year II and also held the role of Dean of Research.

“It was very avant-garde at the time,” says Cassidy. The program worked well. In the hospital the CMCC residents were treated like the medical residents, and performed initial examinations of patients and then reported their findings to the consultant. It gave them confidence and experience in a collaborative health care setting.”

Vernon received his Fellowship in 1981, becoming a highly lauded researcher, editor and spokesperson for chiropractic. Vernon is known for creating The Neck Disability Index (NDI) with Mior. Their 1991 article in the Journal of Manipulative and Physiologic Therapeutics (JMPT) has been recognized as one of the most influential publications for cervical spine research. His PhD thesis investigated the manual therapy for headaches of spinal origin and he edited two text books on the upper cervical spine (1988 & 2003).

Notable success Dr. Silvano Mior (Class of ’80) followed Cassidy into the Clinical Sciences program and has since held a number of executive roles at CMCC. Currently Director, Research Partnerships and Health Policy, he received a PhD from the Department of Health Policy Management and Evaluation, Faculty of Medicine, U of T, and

The Clinical Sciences program has been highly successful in creating a foundation from which scholars, researchers and specialists would flourish. Others who completed the program include Dr. Pierre Côté (Class of ’89), a professor at Ontario Tech University and Canada Research Chair in Disability Prevention and Rehabilitation, and Dr. André

Dr. David Cassidy

Bussières (Class of ’91), an educator at McGill and UQTR, who led the Canadian Chiropractic Guideline Initiative from 2012-2018. At Cassidy’s estimation, approximately 40 chiropractic residents went through the program. “Word spread about the quality of the program and graduates from LACC, Western States, even National were accepted into the program. Some stayed beyond six months. Dr. Jeff Quon (Class of ‘86), who subsequently earned a PhD, spent a year there. Côté finished his residency and went on to earn a Master’s in Surgery at the University of Saskatoon, before returning to Ontario and earning a PhD in Epidemiology at the University of Toronto. It was an exciting time; a lot of material was published in chiropractic and other journals, which was a focus of the program. The Chiropractic Association of Saskatchewan engendered a good relation with the provincial medical doctors. The outpatient chiropractic clinic was entirely medical referral.” Cassidy went on to complete his Master’s and his PhD at the University of Saskatoon, and his DrMedSc in epidemiology at the Karolinska

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Dr. Igor Steiman

Institute in Sweden. He has held several senior positions in Canadian universities and at the University of Southern Denmark. Drs. Cassidy and Kirkaldy Willis ran the program until KW’s retirement in 1990, after which CMCC residents remained in Ontario for their residency training. Residency opportunities have greatly expanded, thanks in part to the program that has provided the exceptional training to its Fellows, and who have, in turn, held the doors open for others. Reflections on the program Dr. Igor Steiman became a Fellow in ’86 and was Director of Graduate Studies and Coordinator of the Clinical Sciences Residency from ’94 to ‘99. Today, he is a professor of clinical education at CMCC and holds a position as a senior clinician in the Department of Family and Community Medicine at St. Michael’s Hospital. Steiman says the program was important to his current position with the hospital – a Fellowship was a prerequisite -- and that it taught him to be comfortable with the uncertainty that can arise with complex cases and how to problem-solve. “No one likes uncertainty, particularly in health care, but it is always there.”

Having the ability to problem-solve allows you to use the evidence, but also to extrapolate and balance it with the situation at hand, to continue to respond to it. “There are three pillars to evidence-based practice,” he explained. “The research of course, but also the experience of the clinician, and the preference of the patient. These last two pillars are often forgotten.” Steiman cited an example of someone who followed a study to the letter, discharging a patient before he had received adequate treatment, simply because the study had included only six treatments. “Judgement is paramount,” he says. “Research is not the reality – it approximates it; practice is reality. To manage a case using research alone is like the tail wagging the dog.” Residents had access to exciting research. Mior recalls having the opportunity to participate in advanced gait research, working with the anatomist at Saskatoon’s Royal University Hospital. “The research I was involved in was led by Dr. Bruce Brandell, an anatomy researcher at University of Saskatchewan in 1981. He was investigating the sequential muscle activation during walking. In understanding the sequential activation and relaxation pattern of muscles in the lower limb, one can use computer programing to activate external muscle stimulators to mimic the pattern and simulate walking. If successful, this could be used in paraplegic patients to enable them to walk with external muscle stimulation.” “Along with David Cassidy, KW was very influential in developing my interest in collaborative health care and the role of conservative care in managing complex spine cases,” says Mior. “He was one of my mentors and advanced my knowledge and commitment to clinical research.” Mior says that the graduate program put CMCC

in a leadership position within chiropractic research and the academic preparation of its faculty when it began, and continues to provide unique experiential training to chiropractors, enabling them to continue to pursue challenging questions pertaining to why and how chiropractic works and operates within a larger context. CMCC’s Residency programs today In August 2020, CMCC welcomed its most recent cohort of graduate students into its three programs – Clinical Sciences, Sports Sciences and Diagnostic Imaging - offering them opportunities for specialized, hands-on experience in hospitals, clinics, sports and industry along with research opportunities and individualized study programs. The director of the program, Dr. Paula Stern (Class of ‘91), says that the mix of practica and individuallytailored studies enabled students to move online during COVID-19 concerns and continue their studies largely unhindered, offering recent graduates the opportunity to learn in multidisciplinary settings and to contribute to meaningful research. Each of the three programs has continued throughout the year, pivoting to online studies as needed. Dr. Stephanie Alexopulos (Class of ’19) is in her second year of the Clinical Sciences residency program. Inspired by her interactions with residents during her undergraduate years, she looked further into the program and realized the combination of teaching and learning was right for her. During her first year in residency, she shadowed at Hamilton General Hospital fracture clinic and was able to follow patients from pre- to post-surgery care, an experience she called “amazing.” She was able to complete that rotation before continuing at St. Michael’s Hospital when COVID-19 struck. At that time,

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she says, her placement went virtual and she participated in wellness check-ins that were instated by Dr. Deborah Kopansky-Giles (Class of ’82), her supervisor at the hospital. They identified over 2,000 patients and contacted each one to ensure they were able to access medication and the necessities of life as the city closed down during the pandemic. Alexopulos treated an older population and found the initiative was very helpful in keeping them supported and well during this stressful time. (As of the time of writing, the residents have returned to their placements.) A new advantage Aside from the ‘first-offs’ Alexopulos experienced in the program and during the change due to COVID-19, she is the first resident to undertake a bridge program between CMCC and Institute of Health Policy Management and Evaluation (IHPME), University of Toronto (U of T) that will allow her to complete her Master’s degree through U of T

as well as completing the residency program and writing her Clinical Sciences Fellowship exam. The Master’s degree will open the door for a potential PhD down the road, so she sees multiple advantages to the program. In terms of research, Alexopulos is excited to be working with the University of Denmark, with which CMCC has a Memorandum of Understanding. She has been studying the GLA:D for Back program to determine whether there is an association between completion of the program and increased functionality of patients suffering from back pain. CMCC's graduate programs have produced over 110 graduates since 1975 who have become recognised leaders in academia, research, health administration and politics. Alumni can be found as members of national and international elite sports teams, executives, clinicians and scientists within university and

DAVID DRUM: THE FIRST 3D MODELS OF THE SPINE, DEFINING SUBLUXATION

Through their research and study, early researchers at CMCC concluded early on that bioengineering concepts could be applied to human locomotion. They began working with Lyman Johnston, who combined his engineering skills with his chiropractic skills to develop 3D models of the spine. Together, they felt they could put a framework together for chiropractic and develop a scope of practice. Striving to keep it simple, the group described three types of

Dr. Stephanie Alexopulos

chiropractic programs around the world.

References Vernon, H. (2013) The life and contribution of Dr. Ronald Gitelman: a pioneer of modern chiropractic science (J Can Chiropr Assoc). 57(1): 10–17. PMCID: PMC3580999 PMID: 23482630

subluxation: 1) hypermobility which needed to be stabilized, 2) fixated or immobilized joints that needed to be mobilized and 3) compressed spinal cord or nerves which would need to be decompressed. In this way, says Drum, the therapeutic goals were simple and clear cut. Drum began to invite specialists from his network to lecture at CMCC, introducing the first multidisciplinary lectures to students and recalls bumping against the old guard, those who were still firmly entrenched in the vitalism from which both medicine and chiropractic grew.

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"’Mixers’, says Drum, "were disparaged as compromising the ‘hands only’ manipulative art of the founders with the addition of physiotherapy, massage, electromechanical devices and even nutritional advice associated with naturopathy. Purists adhered to spinal-pelvic manipulative therapy and many of them were systems practitioners that followed chiropractors who had evolved their own systems of spinal analysis and therapy. None of these systems were based on much research or clinical trials. They were supported by the charisma of their founders and anecdotal case histories. Most

of these techniques were offered at post graduate seminars. There were copious notes provided and ongoing personal instruction. None of this was peer reviewed but I certainly enjoyed meeting these very charismatic pioneers of manipulative systems who were doing their best to fill a vacuum at the time. Most of them were highly skilled practitioners and enjoyed an intuitive diagnostic facility. I learned a great deal from them. He credits Dr. John Colwill, from the Orthopaedic and Arthritic Hospital for lecturing at his undergraduate and postgraduate courses without

of others, and applied it to their patients.” As time went on, the desire for research and for the application of scientific methodologies grew, along with increased exposure and collaboration with medicine.

Dr. Jean Moss (Class of ’70, CMCC President Emerita), was a CMCC student when the emphasis on research began to grow. She recalls that CMCC attracted inquisitive minds. “Very early on, faculty looked at the research, which was very limited at the time, their own anecdotal results and those

Moss acknowledges that at the time, there was tremendous antipathy towards chiropractic from medicine. In fact, medical doctors were not supposed to refer or receive referrals from chiropractors. However, privately, chiropractors could create better working relationships. Moss and Dr. David Drum, practiced together and they established several strong relationships with local MDs and specialists. Moss believed strongly that an educational institution should have a robust research department and during her presidency, CMCC’s research division grew to one of the most productive among chiropractic

charging. Colwill, says Drum, had been a Vietnam war trauma surgeon and was both dedicated and generous with his time. Meanwhile, Drum was also working at Wellesley Hospital, joining rounds with Dr. Charles Godfrey, head of physical medicine, while teaching manipulation. Initially, Drum says he met with resistance from the hospital physiotherapists, but dealt with it by providing them with lessons in manipulative therapy. Drum’s work with the Wellesley Hospital laid the foundation for more opportunities for CMCC down the road.

institutions. CMCC research faculty broke many barriers in the research world which contributed to chiropractic’s evolving relationship with allopathic medicine. She was also instrumental in establishing the McMorland Family Research Chair in Mechanobiology, held by Dr. Samuel Howarth, making CMCC the only chiropractic institution to have a Chair in chiropractic. The evolving relationship with allopathic medicine was assisted by other strategies such as improved student education, ongoing community outreach and the successful integration of CMCC chiropractic clinics into Toronto teaching hospitals, beginning with Wellesley Central Hospital in the 1990s. When the Wellesley Central Hospital closed in 2004, the program moved to St. Michael’s Hospital which led to a series of stronger interprofessional relationships and collaborations.

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CMCC CONGRATULATES DR. JOHN DEFINNEY ONTARIO CHIROPRACTIC ASSOCIATION’S CHIROPRACTOR OF THE YEAR FOR 2020 "John DeFinney is a loyal friend, a dedicated chiropractor and a very humble man..."

Motion Walk/Run. Backs in Motion is an event that was initiated to support CMCC’s clinic and which over the years has contributed thousands to the clinic, to research programs, infrastructure and curriculum delivery. DeFinney coordinated the run from 1983 to 2020 and continues to assist with its logistics. Dr. John DeFinney was honoured this year by the Ontario Chiropractic Association for his significant contributions to chiropractic. Chiropractors are selected for this high achievement in recognition for their work in community services, patient care, research and advocacy. DeFinney was recognized in a video tribute by longtime friends and colleagues, Drs. Silvano Mior, Gordon Lawson and Susan Gillis-Lawson, which can be seen at www.cmcc.ca/ coty-tribute-video. Along with his practice, DeFinney has spent his career building the profile of chiropractic sports medicine and is also known for his work with Mior in developing CMCC’s Backs in

Mior calls DeFinney the kind of leader who always motivates and encourages by action. When he first began to think about a run for chiropractic, Mior says he went to DeFinney, the one runner he knew. "I said, 'John, help us out.’ And he did. To date, the run has generated almost $2 million in donations.” Lawson, who has known DeFinney since 1972, says DeFinney brought forward the concept of active care, now standard within chiropractic, and was instrumental in the development of the Academy for Sports Sciences, known today as the Royal College of Chiropractic Sports Sciences (Canada) RCCSS(C). Lawson says he can’t imagine what the profession would be without his contribution.

Gillis-Lawson worked with DeFinney and members of the RCCSS(C) to create the Foundation for the RCCSS (C). She says there was a huge reaction to DeFinney’s decision to retire. “John DeFinney is a loyal friend, a dedicated chiropractor and a very humble man. He has always stepped up to help. He very much deserves this award.”

The following chiropractors were also honoured this year. Congratulations to: Dr. Carlo Ammendolia, winner: Dr. Michael Brickman Heart and Hands Award Winner Dr. Richar Raigoza, winner: Recent Graduate Award Dr. Christopher Morgan, winner: Community Service Award Dr. John Jaskot, winner: Patient Care Award Dr. Carol Ann Weis, winner: Research and Academic Award

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THE RIGHT PAIR OF EYES CAN SAVE THE DAY DR. BILL HSU ON INTERNING IN SASKATOON AS A RESIDENT OF CMCC’S DIAGNOSTIC IMAGING RESIDENCY PROGRAM patient. Hsu spent mornings at the hospital in neurology, rheumatology, neurosurgery and the orthopaedic clinics. As a resident and part of the patient care team, he observed and examined patients. Hsu was fortunate to have access to the imaging studies of the patients and correlate them with clinical information. It was a rich and unique experience working with the specialists from the clinics. “Worth the Saskatoon weather,” he says, noting that “Toronto has nothing on Saskatoon.”

Residents from within the CMCC Diagnostic Imaging Residency program, like that of the Clinical Science Residency program, also rotated through Saskatoon (see page 16: An opportunity in Saskatoon, SK). Dr. Bill Hsu (Class of ’92), DACBR, says that he had the good fortune to be supervised by Dr. Sandra O’Connor (Class of ‘86), who had completed her CMCC radiology

residency the previous year and extended the program by one year as he entered, making it the very first three-year residency that CMCC offered. “It is such a demanding curriculum,” says Hsu. The time spent in Saskatoon was a rewarding learning experience that allowed him to understand radiology in the context of the

Today Hsu is the Associate Professor and Faculty Radiologist in the Division of Clinical Education at CMCC and is the diagnostic imaging expert, reading for CMCC clinics and fielding inquiries from patients and chiropractors across Canada, sharing his knowledge with CMCC students. His early comprehensive training and years of reading diagnostic images have given him a highly discerning eye. He is often able to detect anomalies that have been otherwise missed in several life changing situations.

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One of his memorable cases involved a woman with daily headaches, who was under the care of one of Hsu’s classmates, Dr. Ester Taca-Silberman (Class of ’92). Silberman sent the patient’s neck MRI study to Hsu. In reviewing it, he recognized a rare neurological abnormality of the cerebellum in which the structure herniates through the foramen magnum, a condition known as Arnold-Chiari 1 Malformation. His discovery led to eventual surgery in which her condition was substantially ameliorated.

Another more recent case involved a young man with a gradual onset of low back and right anterior thigh pain. The patient had seen a chiropractor who had ordered images of his spine at an imaging centre. The images were assessed as unremarkable. Through a lucky meeting with a CMCC intern, the individual agreed to come to CMCC Campus Clinic for assessment and treatment, during which time the existing x-rays were studied and Hsu detected a large mediastinal mass that was not reported in the studies. Ordering an additional

x-ray study at CMCC, a diagnosis of lymphoma was contemplated and later confirmed by a nearby hospital. Thankfully, Hsu’s specialized training enabled him to see what others had missed and in doing so, he was able to intervene and get the patient the help he urgently needed. The best part of the story is that by January 2021, after completing treatment for the lymphoma, it was found to be in remission.

CMCC 17th annual

BackSwing ‘21 SAVE THE DATE Thursday, September 9, 2021 Bayview Golf and Country Club, Thornhill, Ontario

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CMCC DONOR UPDATE

2020 has certainly been a year of challenges, adaptations and new initiatives. Your contributions to innovative research and learning vehicles have helped to make these projects possible. Thank you! Our latest projects are summarized by research area: Research Area: Physiological Effect of Chiropractic Adjustments The Life Sciences Laboratories at CMCC focus on resolving the underlying neurobiological mechanisms of chiropractic care. Among the interesting research projects currently underway: Researchers at CMCC have completed two studies of the physiological effects of spinal manipulation in asymptomatic populations. Perhaps

not surprisingly, these studies show that not all adjustments are created equal! Different adjustments have different physiological effects in terms of autonomic nervous system responses and responses in blood biomarkers. CMCC is now in discussions with a large pain management institute to extend this work and conduct collaborative studies on patients with severe, chronic neck pain. In collaboration with our Department of Anatomy, the Life Sciences Laboratories have completed the preparation of thousands of microscopic sections of human vertebral arteries and we are now quantifying the density of innervation of different regions of these arteries. This work will provide important insights into how

cervical manipulation brings about its important neurologically-mediated effects, and also informs decisions concerning the risks of cervical manipulation. Extending previously published work concerning neck pain, Life Sciences researchers are delving into the molecular mechanisms of low back pain. A recent paper from this lab highlights the different profiles of blood-borne inflammatory markers in patients with acute versus chronic pain. Using advanced techniques such as real-time PCR, our researchers are now looking at how genes related to inflammation are turned on and off following chiropractic treatment. It’s not just about spinal manipulation! A newly initiated study is looking at how it may switch the biochemical

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pathways of inflammation in sensory neurons on and off. Using cultured dorsal root ganglion cells, our researchers are measuring effects on inflammatory cytokines and the genes which up-regulate or down-regulate their production. Research Area: Health Policy and Outcome-Based Research Staying connected to patients beyond the office walls Chiropractors and health care providers have been impacted by the pandemic and challenged in providing patient care. An innovative project conducted at St. Michael’s Hospital focused on how to keep patients at high risk of COVID-19 consequences feeling connected to and supported by their health team during times of isolation and social distancing. A team of health professional Wellness Check-In callers and Subject Matter Experts connected with over 2000 patients in the first wave of COVID-19. Patients and callers were very satisfied with the interaction and processes which are now embedded in usual care. Such studies inform clinical practice and expand opportunities, which can be used by chiropractors to care for their patients under varying circumstances. Optimizing return to work strategies Returning workers to gainful employment is an important aim and involves collaboration of providers and employers. This study compared the return to work (RTW) process for claimants with musculoskeletal (MSK) conditions to those with psychological conditions in Victoria, Australia. Early RTW outcomes were better for those with MSK conditions, and this was largely explained by how their work supervisor responded, RTW planning efforts, offers of work accommodation and differences in mental health problems. When psychological conditions are involved, it was found that consultative RTW planning and work accommodation should be a priority.

Keeping older adults active and healthy Keeping older adults active improves physical, emotional, and quality-of-life outcomes. A recent study assessed the benefits of a community-based exercise program designed to promote, improve, and maintain physical strength, balance, well-being, and social engagement. The program involved 15 minutes of cardiovascular exercise warmup, 30 minutes of upper and lower body strengthening using resistance bands, and a 15 minute cool down (stretching and balance exercises). Regardless of the nature of the exercise, it was found that for older adults participating in such activity improves quality of life, underscoring the importance of encouraging and motivating older adults to participate in exercise and stay active. Research Area: McMorland Family Research Chair in Mechanobiology Chiropractors may use leg length differences in their practice to assess spinal or sacroiliac dysfunctions. To explore this relationship, a study assessed the effects of artificially inducing leg length inequality, using a series of heel lifts on the pelvic torsion and compensatory kinematics of the lower extremities during a functional task. Pelvic torsion and lower extremity movement patterns were measured during a sit-to-stand movement. This project was a collaborative effort between researchers at CMCC and Macquarie University. Using a heel lift to artificially induce an inequality in leg lengths had a statistically significant effect on pelvic range of motion in the transverse plane, but these effects were small and likely not functionally relevant. New Initiatives We are reaching out to you in hopes you will help us through these challenging times. A donation to either one of our new fundraising

initiatives, the PPE Pandemic Fund or the CMCC Student Bursary Fund can make a difference and help us to continue to provide world-class chiropractic education, research and patient care. CMCC remains committed to adhering to public health guidelines by providing our faculty, staff, and students, with the necessary PPE equipment, as well as ensuring our physical facilities provide a safe environment for both our employees and our clinic patients. These unprecedented measures have increased our expenses beyond what was anticipated, and consequently placed a strain on our contingency fund. The pandemic has also had a serious impact on the employment of many of our students. Typical student employers such as restaurants, and gyms, were forced to close their businesses under the provincial regulations. Many of these businesses remain closed, consequently having a serious impact on the finances of many students and their families. Please consider becoming a monthly donor, or if this is not possible, making a one-time online or cheque donation would not only be helpful, but very much appreciated. To learn more about these projects and how you can support CMCC research, please contact: Peter S.Y. Kim, BSc, DC, FCCS(C) Director, Development and Clinic Advancement pkim@cmcc.ca 647 534 3741 Canadian Memorial Chiropractic College 6100 Leslie Street Toronto, ON M2H 3J1 www.cmcc.ca/support Charitable Registration Number: 108075508RR001

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IN MEMORIAM

Dr. Bruno Bastien Class of ’66

Dr. John Hinwood Class of ’77

Dr. Graham Hunt Class of ’69

Ronald A. Oswald Class of '57

Dr. Jeremiah Singh Class of ’01

Dr. Michael Titchener Class of’84

Dr. Rodney Myers Class of ‘78

CMCC is grateful to its supporters who have thought to include a donation to CMCC in recognition of the passing of their loved one. Memorial cards are available through Donation Services at 416 482 2340 ext. 194.

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PASSAGES Contributed by Dr. Jean Moss: Kay Turner was the wife of Dr. W. Darrell Turner, Class of 1957 and a Governor’s Club member since its inception in 1982.

Kay Turner

Kay Turner, the wife of Darryl Turner. It sounds so simple, and yet it means so much. One thing that is not clearly understood today is the importance of the role the wives of early chiropractors played in their husband’s professional lives. For the most part, chiropractors were ostracised, and this had a tremendous impact on their families. Wives had to support their children, sometimes made fun of at school, while dealing with their own isolation.

Contributed by Dr. Jean Moss: Norm McLeod was a public member of CMCC’s Board of Governors from 1992 to 1996.

Norman McLeod

Norm had been involved in the Liberal party for many years and was beginning to slow down a little when he joined CMCC’s Board in 1992. He was a wonderful warm person who would sit in the board meetings listen intently and add very inciteful comments after everyone else had spoken. He always had good advice for us on dealing with the many political situations that

Kay was one of these wives and she did a fabulous job. But she was also a feisty Scottish gal who loved Scottish dancing, travelled with Darrell around the world, and drove on the back of his motor bike as they explored Canada from coast to coast. She had an abiding love of her family members, including children Brian, Heather and Kevin, their spouses and children. I remember her telling me about a trip she made to Scotland and England with her grandchildren. Kay and Darrell strongly supported CMCC and we enjoyed each other’s company. Each visit to BC and their visits to Toronto and CMCC were a chance to catch up and have a good laugh.

arose. He attended all the social events and was often accompanied by his lovely wife, Jean. We were disappointed when he decided to reduce his contributions to the many boards in which he was involved. But he stayed on CMCC’s Board longer than many of the others. Many years later I ran into Norm and discovered why he had remained with CMCC for so long. He said “he didn’t particularly like board work but of all the Boards he had been on, he had enjoyed his time on CMCC’s the most.”

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PASSAGE

Dr. Alan Adams

It is with sadness that we announce the passing of Dr. Alan Adams, Dean at CMCC from 1979 to 1984. Dr. Adams came to CMCC during a sensitive time in the profession and played an important role in developing CMCC and chiropractic in Canada. While all deans and presidents of every college face challenges, those that plagued CMCC during Adam’s tenure were of particular importance. The manner in which he attended to them transformed CMCC and laid the foundation for its continued development. While Dean, Adams enhanced scholarship and developed the library, hiring librarian Claire Callaghan to build the collection and transform it to one of the best chiropractic libraries in North America. He improved capacity in the basic sciences by hiring anatomist John Duckworth MBBCh, MD for whom the CMCC anatomy museum is

named, and by inviting guest lecturers from U of T to share their expertise. Adams is credited for introducing problem-based learning to CMCC through Dr. John Mrozek, whom Adams sent to McMaster, resulting in progressive changes to course delivery. Adams was supported in his work at CMCC by his wife Sharon who not only relocated to Canada with him, but went on to complete her MBA at York University and launch her own career. According to Allan Freedman, CMCC’s legal counsel, Alan “approached all of the “hurdles” with deep reflection and the patience of a saint. His quiet demeanor was one of his greatest attributes and allowed CMCC to move through important transitions in its history.” Dr. Ian Coulter became CMCC Vice President during Adams’ tenure and remembers Adams as a dear friend whose “commitment to the profession was never about

personal ambition but about advancing the best interest for the profession. Alan was without a doubt the best educationalist I ever met and his whole career was about improving chiropractic education.” On the subject of the library, Coulter says “The only better library was Alan’s own which was so large that on one occasion he was told to strengthen the floors in his home to accommodate the weight of the books, there being a goodly chance the floor would collapse. Not only did he have the largest library I ever encountered, but he had also read all of the books. He was without doubt the best-read individual in the profession. On numerous occasions I would introduce him to colleagues from the university and he would stagger them by quoting their own work to them.” Following his tenure at CMCC, Adams joined Los Angeles Chiropractic College (LACC) as VP of Professional Affairs in the

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Clinical Sciences Department. While at LACC, he was the liaison with the Japanese Chiropractic College, teaching classes in Japan and in California. An author as well as reader, Adams wrote many articles and several books for chiropractic publications. In 2005, Dr. Adams joined Texas Chiropractic College (TCC), in Pasadena, Texas, as VP of Academics and Program Development, retiring from his fulltime position in 2012, to teach lab diagnosis.

Dr. Kim Ross, Acting Director Curriculum Design and Mapping, recalls CMCC under Adams’ tenure: When I arrived at CMCC as a student in 1983, I was quite surprised to see that the sciences were being delivered by specialists from the University of Toronto and other universities. The people who taught me Anatomy (Dr. John Duckworth), Histology (Dr. Bill Peek), Embryology (Roy Webb), Physiology (Drs. Ackermann, Sonnenberg), Microbiology (Drs. Injeyan, Landi, Franklin) and Pathology (Drs. Huang, Kerenyi, Kolin) were all secured by my dean (whom I didn't know at the time), Dr. Al Adams. I just assumed that it had always been this way. I met Al in 1995 at a Research Agenda Conference (RAC) in Chicago. Dr. John Mrozek introduced me and later told me how Al had been a major contributor to the curriculum in the early 80s. From that point onward, Al always recognized me and called me by name at every ACC/RAC conference. He knew every paper I had written and who I wrote it with. He somehow knew me like someone who was still at CMCC. Sadly, it was not until Al passed that I fully understood exactly how much he had contributed

to the CMCC that I experienced then, and continue to benefit from today. After Al's passing I reached out to people who were at CMCC during his tenure to inform them of the sad news. This email thread went viral. Dr. Ian Coulter, who was president while Al was dean, told story after story about Al's contributions in terms of acquiring the faculty that I described above, but how he also embraced and launched problem-based learning (PBL) at CMCC. This method was to learn the curriculum by using a case-based approach so that all the material was relevant to the learner. Between Ian Coulter, Allan Freedman, Drs. Stu Kinsinger, John Mrozek, Mike Wiles, Steve Injeyan, Jean Moss, David Wickes, Gord Lawson, Sil Mior, John Taylor, Kitch Hayman, Tony Tibbles, Igor Steiman and Adrian Grice, the stories flooded in for nearly two weeks. When these stories were laid out, I realized that I just happened to arrive at CMCC at a fortunate time. Many of those mentioned above were instrumental in putting together Al's plan for a world class teaching institution. The team of Adams and Coulter and the entire supporting group gave me an education that I ignorantly thought I was simply entitled to. But more than that, their contribution made CMCC what it is today.

Dr. Jean Moss, CMCC President Emerita reflects on Adams’ contributions to CMCC As has been mentioned by many people, Al Adams read prodigiously and had a collection of books that would rival many libraries and was conversant with the latest research. He had an ability to approach people on their level, whether he was talking to a professor or to a student he was encouraging to reach for a graduate degree.

With his unique ability to build bridges with people and institutions, he furthered CMCC’s relationship with other institutions, attracted non-chiropractic biological science faculty, and developed relations with other academic institutions. Among those he brought to CMCC were specialists from the University of Toronto, which we had previously been unable to attract. His mission was to improve the education of chiropractors and CMCC was his laboratory. It was a time of change in medical education and McMaster university had recently begun delivering their medical curriculum through a problem-based/case-based approach. This was revolutionary and a first for Canada. Al saw immediately which methods were applicable to CMCC and would enhance education and clinical practice. He invited experts to CMCC and encouraged faculty to try new methods, resulting in enhanced curricular delivery and making CMCC a leader in chiropractic education. Al was adamant that chiropractors would only become full members of the health care team when we were engaged in good quality, publishable research. To that end, he knew that we had to build a cadre of researchers, and he challenged faculty to seek graduate degrees. These individuals formed a formidable group who advanced the profession by breaking barriers through publishing their results in peer reviewed medical journals and collaborating on research with other health professionals. CMCC backed these efforts and became a leader in musculoskeletal research. The modern CMCC has much to thank Al for. Without him, the transition to an institution of excellence would have taken much longer.

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DONATIONS The donations listed here were received and processed between October 1, 2020 and February 28, 2021 for: Research Chair, Awards and Scholarships, Backs in Motion, Gifts in Kind, In Memoriam and general donations. We extend our sincere appreciation to those who have made gifts to CMCC. If you have a correction to this list or would like more information about making a donation, please call Donation Services at 416 482 2340 ext. 194.

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Mrs. Adrienne M. Johnson Dr. Stephanie E. Johnston Dr. Curtis A. Jurgens Dr. Rahim Karim Dr. Mohsen Kazemi Dr. Terence M. Kehler Dr. Joseph R. Kelly Dr. Donald J. Kelm Dr. Thomas F. Kerr Dr. Peter S. Y. Kim Dr. Kenneth W. Kinakin Dr. Randy A. Kobayashi Dr. Sasha Kobrossi Dr. Mallory K. Kohlmeier Dr. Richard H. Kolanos Dr. Bryan J. Kolisnyk Dr. Shane B. Kraft Dr. Kevyn R. Kristmanson Dr. Melanie Lachapelle Dr. Garth W. LaPlante Dr. Robert A. Laquerre Dr. Thanh Le Dr. David Lee Lee Chiropractic & Sports Therapy Clinic Dr. Michelle C. Liberty Dr. Raphael Lindsay Ms. Wendy Lo Dr. Bradley D. Luther Dr. Kristine A. Lyons Dr. Ward D. MacDonald Dr. Altaz Madhavji Dr. Kevin G. Mahoney Dr. Katie Malone Dr. Sandra J. Malpass Maple Leaf Sports & Entertainment Dr. Victoria L. Marshall Dr. Bruce Mason Massage Addict Ms. Margaret McCallen Dr. Dorothea McCallum Dr. Jason D. McDonald

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Dr. Shane H. Taylor Dr. Cecile A. Thackeray The Co-operators Group Insurance The Orthotic Group Dr. Nicole Therrien Dr. Richard R. Thompson Thumper Massager Inc. Dr. Anthony Tibbles Dr. Filipe Tiburcio Trainer's Choice Dr. Astrid Trim Dr. Natalia Tukhareli Dr. Jennifer Turpin Dr. Paul D. Uchikata Dr. Cynthia van Hellemond Ms. Alwilda Van Ryswyk Dr. John W. Vargo Dr. Marcia Veitch Dr. Michael Vilkas Dr. Darrell J. Wade Dr. Robert A. Weinper Dr. Kathy Wickens Dr. David Wickes Dr. Darin Willar Dr. Matt G. R. Williams Dr. James W. Wilson Dr. N. Scott C. Wilson Dr. Robert M. & Mrs. Anne Wingfield Mr. Ernest Wolkin Dr. P. Gregory Woolfrey Dr. Dean J. Wright York-Peel Chiropractic Society Dr. Tim Zafiris Dr. Patrick Zak

Primary Contact - Spring 2021

GO GREEN GO PAPERLESS WHERE POSSIBLE. Offering patients the option of electronic billing and paperless receipts at the office has become a practice standard. Do the same at home and have regular statements such as monthly bank or electricity bills sent to your e-mail instead, where they are accessible, secure, and organized for future review. A growing number of retail outlets are offering the same option. It’s a small change of habit with so many benefits.

Spring 2021 Volume 59 / Issue 2 Primary Contact is published twice a year by the Division of Marketing and Communications at CMCC. Your opinions, comments, and input are important to us. Do you have suggestions for topics we can cover? Phone: 416 482 2340 ext. 217 Fax: 416 482 3629 communications@cmcc.ca Other frequently requested email addresses: admissions@cmcc.ca alumni@cmcc.ca board@cmcc.ca development@cmcc.ca events@cmcc.ca govclub@cmcc.ca membership@cmcc.ca president@cmcc.ca Executive Editor: Shannon Clark Contributing Editors/Writers: Mara Bartolucci Margaret McCallen Art Director: Dora Kussulas Photography: istockphoto.com CMCC Media Services Associate Vice President, Institutional Advancement & Communications: Mara Bartolucci Director, Alumni Relations: David Coleman Director, Development and Clinic Advancement: Dr. Peter Kim

CMCC does not necessarily endorse or approve advertisements published in Primary Contact. Opinions of individual authors do not necessarily reflect the views of CMCC. Publications Mail Agreement Number: 40062432 Change of address and undeliverable copies should be sent to: CMCC Alumni Relations Office 6100 Leslie Street Toronto, ON M2H 3J1 cmcc.ca Twitter @cmccnews Facebook.com/cmccnews Instagram @cmccnewsandevents

CMCC MEMBERSHIP…TOGETHER WE CAN SOAR TO NEW HEIGHTS!

In a world which has taken hold of our everyday lives, in which online streaming and social distancing are the norm, imagine being able to break free and choose one’s journey, free of restrictions. Imagine being able to go anywhere unimpeded and unimagined. Like a bird soaring above, you have the freedom to decide your path and your destination. You are not alone! You and the many other CMCC members across Canada and around the world are on a journey together to support CMCC, ensuring we stay strong, that we remain on track and that our future is bright…for our students and for chiropractic. To our members, we thank you for your loyalty and for staying with us through this difficult period. You too can be a member and join us on this exciting journey. You can renew if you were a member last year, you can rejoin if you have been a member in the past or simply become a new member! Go to the membership and perks section on the CMCC website and choose whichever category applies to you, or send an email to membership@cmcc.ca A comprehensive benefits program lies ahead along with significant savings for your practice and personal needs as well as a business receipt. Join us as we take flight and soar to new heights. Your support will make a difference!

For further information please contact: David Coleman Director, Membership and Alumni Relations C: 437 228 9747 Email: dcoleman@cmcc.ca

CMCC 38th Annual

VIRTUAL BACKS IN MOTION This year, we are offering you more WALK - RUN - CYCLE 5km, 10km, or Challenge!

SUNDAY, MAY 9, 2021 VIRTUAL KICKOFF! Choose your activity and move forward with us May 9 – 31, 2021

cmcc.ca/backsinmotion Due to health and safety concerns pertaining to the coronavirus, this event will be virtual.