Dalhousie Medical School Annual Report 2017 – 2018
A Brief History Dalhousie Medical School's roots stretch back to September of 1843, when the Dalhousie College Act specified that a medical faculty be established within the college. With the support of the premier and a provincially-funded hospital located on the South Common, the Faculty of Medicine began its work in 1868, about 50 years after the founding of Dalhousie University. The Dalhousie University Medical School’s rich and diverse history has culminated in our position today as one of Canada’s leading medical schools. The medical school has long focused on excellence in medical education. For 150 years, the faculty has been training students to become physicians and scientists, many of whom have made their mark on the national and international stage. Almost as old as the country itself, the Dalhousie Medical School has endured two world wars, the Halifax Explosion, and numerous government and physical changes. An integral part of Maritime Canada since 1868, Dalhousie Medical School's success has always been linked to our relevance to the communities we serve. While most Maritime doctors earned their MDs at Dalhousie, our well-trained, highly skilled graduates can be found caring for people of all ages throughout Canada and around the world.
Message from the Dean
2018 represents a year of celebration for the Faculty of Medicine. It was December in 1867 when organizers gathered at the home of surgeon Dr. Edward Farrell to chart out a plan to form a faculty of medicine at what was then Dalhousie College. By February 1868, the board made up of a small group of Halifax physicians and surgeons was approving the proposal and lectures would begin in the spring. Throughout 2018, we have celebrated 150 years of excellence in education, research and service in Maritime Canada. We also recognized our pioneers who have accomplished well-known and celebrated medical achievements that have revolutionized medicine to present day. Building on the legacies of many, we have risen to great heights, with unprecedented growth and success in every aspect of our mission to inspire and enable excellence in health care through our medical education and research programs, and to serve and engage society. It’s been a busy and productive year at Dalhousie Medical School, and we are proud to share some of the many highlights and accomplishments achieved by our talented and dedicated faculty, students and staff. As you will see through our shared stories, we have reached new levels across all measures of performance. I am grateful we can celebrate together the tremendous accomplishments of the past year. At the same time, we can reflect on our rich 150 years of history as an academic medical institution. My sincerest thanks to our faculty, staff, students, residents, fellows, alumni, patients and donors – everyone who is a part of the Dalhousie Medical School community. As we move forward, you have always been – and will continue to be – the reason for our success.
David Anderson, MD Dean, Dalhousie Medical School
KEY FOCUS AREAS
SPOTLIGHT ON RESEARCH Making Waves Dalhousie Medical School has announced its leading research teams and strategic research priorities, following a months-long application and review process known as “The Wave.” The goal of the process was to reveal the medical school’s strongest research teams, uncover their aspirations, and identify what they need to take their work to the next level.
International Leadership in Health Research Research that is Responsive to Health Needs across the Maritimes
A total of 27 research teams, involving 275 researchers, submitted Wave applications in the spring of 2017; a panel of senior research, health care and development experts — chaired by Dr. Tom Marrie, former Dean of Medicine — reviewed the applications over the summer and early fall.
The medical school announced the results of the panel’s deliberations at a celebration in October, identifying two Wave 1 teams (Genomics in Medicine and 13V: Infection, Immunity, Inflammation & Vaccinology) and two Wave 2 teams (The Health Priorities Cluster and Cardiovascular Diseases in Vulnerable Populations). The next wave that is expected crest in 2019 is Dalhousie’s Brain Repair Centre team, which is made up of scientists and clinicians affiliated with Dalhousie University, the Nova Scotia Health Authority, and the IWK Health Centre. Identified as a priority Wave research team, these researchers and clinicians are tackling an array of devastating conditions involving the brain and nervous system, including MS, dementia and Alzheimer’s disease, traumatic brain injuries, ALS, spinal cord injuries and Parkinson’s disease. Recognizing that management is simply not enough, this team is actively pursuing ways to both prevent, and treat, these life-altering conditions. In support of this cutting-edge research group, Dalhousie’s Faculty of Medicine is actively working to raise $5 Million over five years to enable the development of new technologies and discoveries that can help stave off neurological disease, and transform lives.
Wave 1 research teams:
Genomics in Medicine
Infection, Immunity, Inflammation & Vaccinology (I3V)
Wave 2 research teams:
IMPART – CVRG (Cardiovascular Research Group)
Health Priorities Research Cluster
U.S. National Institutes of Health (NIH) awards Dalhousie led project $3.2 million to develop new immunotherapy drugs for advanced melanoma Dr. Gujar is working on the NIH-funded project to develop new immunotherapies for advanced melanoma, the deadliest form of skin cancer. He and a team of researchers have created photo-sensitive ruthenium metal-based compounds that can be applied to melanoma lesions on the skin. When activated by a specific wavelength of light, these compounds kill melanoma cells and, in the process, “teach” the immune system to recognize and eliminate metastatic cancer cells circulating in the body.
A new kind of Dragon’s Den In April 2018, the Saint John Regional Hospital Foundation hosted its own “Medical Dragon’s Den.” Dr. Keith Brunt, researcher and associate professor in the Department of Pharmacology at Dalhousie Medicine New Brunswick (DMNB), and his IMPART team (comprised of DMNB faculty members Dr. Brunt, Dr. Sorab Lutchmedial, an interventional cardiologist at the Saint John Regional Hospital, and Dr. Jean-François Légaré, head of cardiac surgery at the Saint John Regional Hospital) pitched the purchase of a Nobel-prize winning super-resolution microscope to the Dragons and walked away with the top prize of half a million dollars. The microscope is the first of its kind in Canada dedicated to clinical research.
Revolutionary researcher on the path to early detection of Alzheimer's disease When Dr. Sultan Darvesh (MD’88) was completing his residency in Neurology with Dalhousie University’s Faculty of
Medicine in the early 1990s, he often asked his mentors for advice on what to research in his medical career. Nearly 25 years later, Dr. Darvesh, a professor with the Division of Neurology in the Department of Medicine and the Department of Medical Neuroscience at Dalhousie, is on the verge of a significant breakthrough in combatting a disease that affects approximately 35 million people worldwide: Alzheimer’s disease.
Working with a team of researchers, he has developed a small radioactive molecule that can positively identify butyrylcholinesterase, an enzyme that plays a key role in the progression of Alzheimer’s disease in PET and SPECT scans. It could, he says, enable a definitive diagnosis of the disease in living patients, something that has never been possible before.
Getting to the heart of heart disease Dr. Petra Kienesberger is an assistant professor in Dalhousie Medical School’s Department of Biochemistry & Molecular Biology and part of a growing nucleus of cardiovascular researchers at Dalhousie Medicine New Brunswick (DMNB). The lipid research scientist has received a four-year, $260,000 Heart and Stroke Foundation of Canada new investigator award and a five-year $685,000 Canadian Institutes of Health Research (CIHR) grant to study how excess body fat weakens the heart.
SPOTLIGHT ON EDUCATION Longitudinal Integrated Clerkship: Learning in rural communities The Longitudinal Integrated Clerkship (LIC) is a model for the third year clerkship in which the core clerkship discipline units are integrated into a year-long program which is based on continuity (of learning, learning environment, supervision and assessment, and patient experiences) and patient-centered care. Dalhousie launched its first LIC program in Saint John in 2010, and the program is now running in four sites in that province. Presently, the program is located in Dr. Everett Chalmers Hospital (Fredericton), Miramichi Regional Hospital, the Moncton Hospital and Upper River Valley Hospital. The Cape Breton Regional Municipality will be the first site in Nova Scotia to house an innovative training program for third-year Dalhousie medical students. The program is set to launch with two students based in New Waterford and another two students based in North Sydney starting in September of 2019.
KEY FOCUS AREAS
Building on Educational Excellence Medical Education responsive to Health Needs of the Maritimes Leadership through Scholarship in Medical Education
Whereas a traditional clerkship would see students stationed in a tertiary care setting (such as Halifax) rotating through various medical disciplines, students in the LIC program spend the entire year based in a family practice, often in a smaller community. In fact, the LIC program has been scientifically proven as one of the best means to attract students to work in generalist specialties and in rural areas, and many students who were trained in the LIC program in New Brunswick have entered practice in New Brunswick.
Residents “learn the ropes" of Competence by Design Competence by Design (CBD) is the Royal College of Physicians and Surgeons of Canada’s model for implementing competency-based medical education (CBME) in all specialist residency training programs in Canada by 2022. Competencybased medical education in general—and Competence by Design in particular—is focused on advancing each individual resident’s progress toward mastering a clearly defined set of skills for their discipline. It allows them to move quickly in areas of particular strength, and take more time in areas they find more challenging.
Research in Medicine: Fostering research skills from the outset of medical training The first program of its kind in Canada, Research in Medicine is a mandatory program that introduces Dalhousie medical students to research from the start of their medical training. From first year on, it fosters their research and critical thinking abilities as they complete independent research projects.
By the time they receive their MD degrees, Dalhousie medical graduates have a thorough understanding of the vital role that research plays in today’s health care system and a strong sense of how they can incorporate research into their medical careers—not only to advance their own practices but to improve the quality and outcomes of care throughout the health care system and around the world.
Dr. Thomas J. Marrie: Accomplished physician, researcher and university leader From humble beginnings as a family physician in his home province of Newfoundland, Dr. Thomas J. Marrie has crafted a truly illustrious career as a medical researcher, teacher, administrator and clinician. This spring, Dr. Marrie, Dalhousie University’s 12th Dean of Medicine, joined thousands of graduates as he walked across the stage to receive an honorary degree from Dalhousie University.
Dal's Medical Sciences Program Prepares Students for Diverse Careers in Health Jarrar made the trek all the way from South India to take part in Dalhousie’s Bachelor of Science in Medical Sciences (BSc Med Sci). He is one of ten graduates from the new medical sciences program who will be embarking on Dalhousie Medical School's MD program next fall. Three faculties, Medicine, Science and Arts & Social Sciences, launched the Medical Sciences BSc program in 2014. Its goal is to provide students with a solid background in human healthoriented science and humanities that will prepare them to pursue a wide range of careers in health care, medical research and beyond.
Bachelor of Medical Science
four-year undergraduate degree program established in 2014 ideal preparation for a career in the health professions, health research, industry or government offered jointly through Dalhousie Medical School and Dalhousie’s faculties of Science and Arts & Social Sciences only program of its kind in Atlantic Canada approximately 400 students in the program first class of 55 students graduated in 2018
20 years of graduate student excellence In the 20 years since Dalhousie Medical School launched its first Graduate Student Research Day, it has given out 20 awards of excellence. These exceptional graduates have since gone on to highly successful careers in industry, government and academia. Today, these Dal graduates are teaching and conducting their own research programs at universities all across Canada and around the world. They are also working in such organizations as the Montreal Neurological Institute, the U.S. Food and Drug Administration, the King Faisal Specialist Hospital and Research Centre in Saudi Arabia and the International Society for Stem Cell Research. Just ask grad student Derek Clements, PhD, who received his doctorate degree from Dalhousie in June. Dr. Clements received the Graduate Student Excellence in Health Research Award from the Faculty of Medicine at its 20th annual Graduate Student Research Day this spring for the high quality of his research, which explored the role of white blood cells, known as myeloid cells, in ovarian cancer and how to manipulate them to fight this deadly cancer.
SPOTLIGHT ON SERVING AND ENGAGING SOCIETY KEY FOCUS AREAS Dal Med Welcomes Dr. Gaynor Watson-Creed,
Assistant Dean, Serving and Engaging Society
Catalyzing Systems Change to Improve Health Outcomes Partnering with Communities for Improved Health Outcomes
A newly established position, the Assistant Dean of Serving and Engaging Society will co-lead Dalhousie's efforts in the development, implementation and outcome assessment of one of the three interdependent pillars of the Faculty of Medicine's Strategic Plan: Serving and Engaging Society. Dr. Watson-Creed will develop and oversee the Faculty of Medicine's efforts to more fully engage faculty, staff, and the community at large in Maritime health outcomes. Under her leadership, the Faculty of Medicine will continue to flourish as a partner and leader in improving health systems of the Maritimes. “The medical school has articulated a vision for improving health in the Maritimes that exceeds its traditional role of educating physicians and conducting leading-edge research,” says Dr. Watson-Creed, who was part of the working group that crafted this vision. “It’s about asking, ‘what is really driving poor health in our communities?’ and, more importantly, ‘what can we, as a medical school, do about it?’ and, ‘are we doing everything we can, to the best of our ability?’” Dr. Watson-Creed looks forward to building on these successes and creating new opportunities for the medical school to catalyze much-needed change in the health care system and partner with communities to improve outcomes in health. One of her first priorities is to examine the medical school’s past and current involvements with communities that have long been marginalized in the Maritimes, such as the region’s Black, Indigenous and immigrant communities, as well as the LGBTQ community, rural communities, and the seniors’ community. Initiatives such as PLANS (Promoting Leadership in health for African Nova Scotians) and Indigenous programs that run summer camps and provide scholarships and support to students have resulted in more Black and Indigenous youth pursuing careers in the health professions. The Service Learning Program, meanwhile, pairs medical students with community organizations to create and deliver new health-supporting programs.
Academic study and community service unite in the spirit of social accountability With the recent advent of Dalhousie Medical School’s Service Learning Program, students are now also spending time in seniors’ homes, food centres, needle exchanges and a host of other locations where grassroots community groups are providing much-needed services and supports. Dalhousie Medical School’s Service Learning Program is part of #DalMedForward. Managed by the Global Health Office, the program matches second-year medical students with community partners to give students a taste of what medical practice might look like outside the clinic or classroom, while helping them learn about the wider community’s needs and resources to inform their future practice.
Diversity programs for African Nova Scotian and Indigenous youth who aspire to pursue a career in medicine In 2017, the PLANS (Promoting Leadership in Health for African Nova Scotians) Prep Institute was launched for students in their final years of high school who were entering university or college. This camp explores health careers in greater depth and builds skills to help students succeed in their first years of post-secondary education. As well, Dalhousie’s Faculty of Medicine Indigenous Health Program provides summer programming for youth from Indigenous communities. The goal of summer programming is to provide Indigenous learners with fun, hands-on, and interactive activities to increase their interest in the health professions. The camp consists of personal development, cultural and recreational activities such as First Nation drumming, swimming and other outdoor activities.
Collaborative efforts lead to better access to more family doctors Nova Scotians will have access to more family doctors with a new family medicine training site in northern Nova Scotia, and the addition of new spaces at several existing sites. The North Nova Family Medicine Teaching site will accept six family medicine residents each year, and new spaces will also be allocated in areas to meet the needs of Nova Scotians. A total of 10 new spaces will be created in Dalhousie University’s Family Medicine Residency Training Program. Residency training is a collaborative effort between the department of Health and Wellness, Dalhousie Medical School, and Nova Scotia Health Authority. Dalhousie’s Department of Family Medicine met with several key groups as part of the consultation phase of this project that led to the implementation of the North Nova Family Medicine site. In addition to the 10 new family medicine residency positions, the province is adding 15 new specialist residency seats to the Dalhousie University medical school by July 2019, bringing the total number at the university to 65. These specialty positions will span across a number of areas such as child and adolescent psychiatry, critical and emergency care, and palliative care.
Study finds Aspirin as effective as prescription meds in preventing post‑op clots Dalhousie’s Dean of Medicine, Dr. David Anderson and Dr. Michael Dunbar, a Dalhousie-NSHA orthopedic surgeon participated in and co-authored a Halifaxbased, cross-Canada study that proved Aspirin is as effective as rivaroxaban in preventing blood clots after hip and knee replacement surgery. The findings, recently published in the New England Journal of Medicine, mean cost savings for patients and an international change in the use of oral anticoagulants to prevent blood clots after these surgeries.
SPOTLIGHT ON ORGANIZATIONAL, OPERATIONAL AND FISCAL RENEWAL Welcome Dalhousie Medical School's first-ever chief operating officer Linda Penny’s path to become the first COO of the medical school reads like a finely-executed plan few others could emulate. She comes to the role after several years as Dalhousie University’s director of budgets and financial analysis but, before that, she worked in leadership roles with Nova Scotia’s Department of Health and Wellness. Over the years, she oversaw strategic planning and financial management for hospital services, infrastructure, long term care, primary care, physician services, emergency health services, public health and mental health services. In fact, she joins an existing cadre of females in senior roles at the medical school—9 of 20 associate and assistant deans are women.
The Diversity in Leadership initiative
WHAT CHARACTERIZES OUR WORK
Excellence, innovation, life-long learning, and evidence-based critical inquiry Relationships that are collegial, collaborative, respectful, and professional Responsiveness to regional, national, and international health needs Integrity, accountability, transparency, and fairness Social responsibility, diversity, and advocacy
In recognition of the fact that diversity, equity and inclusion are essential to our social accountability goals, and to better reflect the communities we serve, in January 2017 the Dean of Medicine established the Diversity in Leadership Task Force with broad representation from across the Faculty of Medicine and the Dalhousie University. The Task Force began with a focus through a gender lens. Although women have been historically underrepresented in leadership positions in academic medicine, the number of women graduating from the medical sciences and medical school specifically has increased rapidly over the past 25 years to greater than half of the recent graduates.
Dalhousie Medical School receives accreditation for eight-year term Dalhousie Medical School’s undergraduate medical education program (the MD program) has received accreditation for an eight-year term. In essence, the accreditation process is an exercise in continuous quality improvement. It is an increasingly collegial effort to help all medical schools in Canada attain and maintain the highest possible standards across all of their education programs, from the MD level through residency training to continuing professional development.
The Process
Tupper Energy Refit
A thorough self-examination, along with corrective action and evaluation to ensure any deficiencies Preparation of a comprehensive series of documents known as data collection instruments (DCIs) that provide detailed information about 94 distinct elements, across 12 broad standards A student-led review of the curriculum, learning environment and student support services An in-depth site visit by representatives of the accrediting bodies
PROJECT OVERVIEW Location: Sir Charles Tupper Medical Building, the Tupper Link building, and the Clinical Research Centre Size: 37 500 m2 Budget: $12m Annual energy savings: $605k Annual Greenhouse Gas (GHG) Emissions reductions: 2,705 tonnes eCO2 Construction start date: November 2015 Construction completion: February 2018
Project Partner: MCW Custom Energy Solutions Ltd.
150th Anniversary In 2018, Dalhousie Medical School celebrates 150 years of research, leadership, innovation and impact. This is a time to reflect on all that has made us a Canadian thought leader, global educator and research powerhouse. It’s also a time to focus on what’s ahead — a new and unprecedented era when we will chart new paths and extend the boundaries of knowledge and intellectual discovery. Our sesquicentennial anniversary has been being celebrated through a series of events taking place at distributed teaching sites across the Maritimes. We are telling the untold stories of our past Deans, worldrenowned researchers, and pioneering faculty members, who have proudly served the Faculty since 1868.
DalMed Innovators The Faculty of Medicine inspires health care through medical education. We inspire by highlighting the untold stories of 12 pioneers through a signature 150th initiative called the Dal Med Innovators.
Dr. Alexander P. Reid Dalhousie’s first dean of medicine.
Dr. Annie Hamilton Annie Hamilton overcame numerous obstacles to become Dalhousie Medical School’s first female graduate in 1894.
Dr. Benge H. Atlee Dalhousie’s youngest-ever medical graduate at age 21, Dr. Benge Atlee later became the first head of Dalhousie’s Department of Obstetrics & Gynecology.
Dr. Chester B. Stewart As dean from 1954 to 1971, Dr. Chester Stewart increased the number of appointments in the medical school from 16 to 160, and 55 graduates in 1960 to 96 first-year students by 1968.
Dr. Lea C. Steeves Dalhousie Medical School’s first director of postgraduate medical education.
Dr. Margaret Casey Dr. Margaret Casey spent 25 years with the North End Clinic on Gottingen Street (now known as the North End Community Health Centre), and was named a Member of the Order of Canada in 2004.
This initiative is an opportunity to honour and learn from our past while inspiring our promising future. It is also a chance to say “thank you" to the generations of scholars and leaders who have inspired and challenged us.
Dr. Richard Goldbloom Dr. Goldbloom was the first physician-in-chief and director of research at the IWK Health Centre.
Dr. Nuala Kenny Dr. Nuala Kenny was a pioneer in the emerging field of bioethics. After retiring in 2009 as Professor Emeritus, Dr. Kenny remains active in the field of ethics and health policy.
Dr. Karen Mann After becoming director of Undergraduate Medical Education in 1986, Dr. Mann championed medical education as a career path
Dr. Joni Guptill Serving as a frontline worker in Africa, Asia and the Middle East, and later as the president of Doctors Without Borders in Canada. Dr. Guptill helped create Dalhousie’s Global Health Office in 2001.
Dr. Robert Johnson Dr. Robert Johnson was the first Mi’kmaq person to receive a medical degree from Dalhousie when he graduated in 1998.
Dr. Chadwick Williams One of the first African Nova Scotians to graduate from Dalhousie Medical School. In 2017, six African-descended students graduated from Dalhousie Medical School – the most ever – and six more received MDs in 2018.
DALHOUSIE MEDICAL SCHOOL BY NUMBERS
467 medical students 121 graduate students 604 residents (132 Family Medicine, 472 Royal College specialties) 29 research chairs (17 endowed chairs, 12 Canada Research Chairs) 146 basic science faculty 2,253 clinical faculty members 802 staff members 22 departments 92 family medicine and 156 residency teaching sites in the Maritimes 30 New Brunswick students admitted to Dalhousie Medicine New Brunswick (DMNB) each year 5 teaching sites throughout Dalhousie Medicine New Brunswick including Fredericton, Miramichi, Moncton, Saint John and Waterville
RESEARCH FUNDING HIGHLIGHTS
$7.7 million in project grant funding, CIHR fall 2017 competition Success rate higher than national average Three applications ranked #1 by review committees $10 million for Canadian Immunization Research Network CIHR successes in Alzheimer’s disease, arthritis, back pain, cancer treatment, cannabis links to psychosis, cardiac health, frailty, immunology, primary care, palliative care and more $3.2 million National Institutes of Health (U.S.) melanoma immunotherapy
Research Funding Faculty of Medicine 2017-18 (in thousands of dollars) Student Salary Awards, 1,600 Salary Awards, 1,500
Equipment, 4,800
Clinical Trials, 15,400 Research Grants, 32,300
medicine.dal.ca/annualreport medical.communications@dal.ca (902) 494-6592