2023 Department of Medicine Annual Report

DEPARTMENT OF MEDICINE

ANNUAL REPORT DIRECTOR’S CUT

DEVELOPMENT

Ada Prunescu

Communications Officer

McGill Department of Medicine

DESIGNER

Steven McClenaghan and Julie Roussy

McGill Graphic Design Studio

Communications and Institutional Relations

PHOTOGRAPHERS

Egan/Dufour

Isabelle Dubé

Fractional Media

DEPARTMENT OF MEDICINE

McGill University Health Centre

1001 Decarie Boulevard

Mail Drop Number: D05-2214

Suite D05-2212

Montreal (Quebec) H4A 3J1

Tel: 514-843-1578

Fax: 514-843-8182

IN THE DOM ONCE UPON A TIME

Chair, Associate Chairs and Director Messages

MESSAGE FROM THE CHAIR OF MEDICINE

Dr. Marc Rodger

DOM by “design”– a great annual report theme to kick off our 2024-2029 strategic plan. We have done the Director’s cut and the film is ready for release!

I thank you for your participation over 2023 in developing OUR strategic plan. It was a wonderful community building exercise. We now have the architect plans- it’s time to build by design.

Things are taking shape. We have re-focused our Graduate Program in Experimental Medicine into our Graduate Program in Clinical and Translational Research. We will be adding two PhD streams: Digital Innovation (AI is/will be everywhere) and Clinical Research. Of course, we will not only preserve but strengthen our Experimental Medicine stream with a growing focus on translational bench research. We are building our “Dual path: Clinical and Research training” program to develop/grow clinician-scientists. This dual path allows residents/fellows from CORE through postRCPS sub-specialty Fellowships to benefit from formal research training (MSc/PhD) alongside clinical training in an integrated and specifically designed clinicianscientist path. This will differentiate us from Canada’s other DOMs, grow our clinician-scientist base and propel us to our goal of becoming the most research-intensive DOM in Canada.

Quebec specific headwinds increasingly mandate that we will have to focus on designing our training programs to train those who will become the next generation of McGill Faculty colleagues. Recruiting anglophones/ allophones from other provinces and countries is a challenge (that can and will continue to be done). We will design integrated French language training (for anglophone trainees) and English language training (for francophone trainees) to recruit/retain the best who want to work at McGill in our wonderful cosmopolitan and vibrant city.

Our health care system is at cross-roads. Demographic and multi-morbidity pressures will mean more demand for DOM services. Prior generations of health system leaders ignored these very foreseeable realities and chose to reduce health care worker training program capacity (MD, RN, LPN, techs, RTs etc.) in a bid to contain short-term costs. What will we do? Innovate. We will embrace EPIC, AI-supported ambient dictation services, physician extenders etc. to provide more care with fewer DOM specialists.

Finally, we will ensure that we “put on our oxygen masks before helping others.” A physician who isn’t well is unable to work effectively at full capacity. Thankfully the “internship” realities I lived through in training are a thing of the past. While I saw a ton, learned a ton and did a ton in my 1:3 36-hour shifts as a rotating intern at an interns-only hospital, I was a zombie at the end of that year and had lost a lot of empathy/compassion in a bid to survive the internship. Today, it is good that current generations demand more reasonable work-life balance and, I believe, better maintain their professionalism, empathy and compassion. Our wellness team is doing a fantastic job in ensuring DOM focuses on balance, building resiliency, normalizing our doubts/uncertainties and developing our social networks.

I have little doubt that we will look back in 2029 on our 2024 design and we will have a Department of Medicine that will intensively pursue excellence, be healthier, efficient in providing care, welcoming and we will “love working here!”

MESSAGE FROM THE ASSOCIATE CHAIR OF MEDICINE Dr. Vicky Tagalakis

In July 2023, I was appointed McGill Associate Chair of Medicine and Physician-in-Chief at the Jewish General Hospital (JGH). I am grateful for the support and well wishes I received from many in the Department. I am also thankful to Marc Rodger and Ernesto Schiffrin for their invaluable guidance, the JGH and McGill Department administrative teams for helping with the transition, and the Division Directors for their leadership and collaboration. Moreover, I extend my gratitude to our education leaders in both undergraduate and postgraduate medicine, as well as the internal medicine residency program directors and lead medical residents.

Reflecting on the past year, I am impressed by the remarkable successes of our Department and the unwavering dedication of its members to our academic mission, all while delivering exemplary patient care. When I was Division Director, I knew of this excellence, but now in my role as Physician-in-Chief at the JGH and Associate Chair of the Department, I can confidently say that I have gained a whole new perspective. Additionally, it has been immensely rewarding working hand in hand with colleagues not only at the JGH but also at the McGill University Health Centre and St Mary’s Hospital Center in a common effort to advance our shared academic initiatives. As you read through this report, you will be equally impressed by the breadth of excellence that permeates our research, clinical teaching and innovative clinical practices across all our divisions and sites.

Equally impressive is the way we have been addressing the numerous challenges we face. The healthcare crisis remains a significant concern. A pressing issue for many of us – and seemingly overlooked by our policymakers – is the growing imbalance between the demand for specialists and their supply – a problem that is worsening. Our patients, living longer with advanced chronic conditions, require specialized care. As we advocate for

the expansion of PEMs or, preferably, their abolishment, and increased support for our clinical programs, we also remain focused on providing quality patient care in our resourceconstrained environments. Fast-track ambulatory clinics, medical day hospitals, telehealth services, hospital at home, and outpatient treatment and diagnostic programs are essential components of a comprehensive approach to health care delivery fostered by innovation and resourcefulness.

In addition, we are committed to supporting our faculty and trainees amidst the high clinical volumes that impact our well-being and threaten our teaching and research missions. The Department’s CAS research, Quality Improvement and Medical Education scholarship awards are focused on protecting and supporting our researchers. The establishment of World Class Teams aims to unite and break down silos across domains and sites, while the Department’s mentorship program reflects our investment in new recruits and their supportive onboarding. Our clinician-teachers are at the forefront of patient care and teaching, responding to the ever-increasing patient volumes in our emergency rooms and wards while maintaining safe learning environments for our trainees. This has been achieved in large part through the creation and expansion of non-teaching units across all sites. It is important we provide our clinician-teachers with opportunities for professional development, recognition and promotion, acknowledging the significant role they play in delivering our academic mission, especially in our residency programs.

In closing, I want to echo the sentiments expressed during our Department’s strategic planning exercise, where the collective aspiration was crystal clear: to foster an environment where each member can genuinely say, “I love working here.” Your dedication and passion make this aspiration a reality, and it’s a privilege to work alongside you. I wholeheartedly share in the sentiment that I love working here and collaborating with you all.

MESSAGE FROM THE DIRECTOR OF SPECIALIZED

MEDICINE ST. MARY’S HOSPITAL CENTER

Dr. Bruce Campbell

St. Mary’s has been in preparatory mode for our upcoming 100th anniversary. This communitybased teaching hospital has come far from its humble beginnings in the old Shawnessy house in 1924, now the home of the Canadian Centre for Architecture. In 2023 the St. Mary’s Department of Specialized Medicine managed to shake off the dust of the last few difficult years and start looking ahead.

Though there were many challenges this year: staff shortages, dreaded problems with fluidity, and scrutiny of the hospital in the ministry and the media, we managed to make strides and learn what was needed from the aftermath of the pandemic. To start, many of our divisions welcomed new members, with geriatrics, internal medicine, gastroenterology, infectious diseases, rheumatology, neurology and dermatology completing hiring or search processes. The department also has a unique relationship to our family medicine colleagues and celebrated three new hospitalist members.

The Hospital also welcomed new leadership. Dan Gabay, our new chief executive, has a fierce commitment to solving problems, promoting technology and returning vital services to local control. The Department was very involved with the development of a new clinical and academic plan. Dr. Ewa Sidorowicz, McGill Department member and former Director of Professional Services at the McGill University Health Centre, led the project with an emphasis on local strengths, clinical excellence and medical education. The process has helped the department clarify its vision.

Department members have been collaborating with the architects on the major infrastructure project, which will greatly benefit McGill activities. New internal medicine wards (90 new beds), teaching spaces, outpatient clinics, day centre and endoscopy suites will enhance the care of our patients in an idealized learning environment. With design on the new wing well underway, the leadership and department members have begun planning much needed renewal of services in the legacy building, including critical care and cardiology.

Great successes this year include the founding of the Geriatric Multidisciplinary team led by Drs. Julia Chabot, Shek Fung and Michael Bonnycastle. Drs. Andrea Blotsky and Carolyne Elbaz were recipients of the quality scholarship grant for St. Mary’s and presented their work at the McGill High Value Health Care symposium. We also celebrate award winning educators and leaders in Dr. Mathieu Walker, who received the Osler Award (his second!) and Dr. Julia Chabot, who received the McGill Department of Medicine Leadership Award for 2023.

Expect more exciting progress in 2024 when we celebrate 100 years.

MESSAGE FROM THE ASSOCIATE CHAIR EDUCATION

Dr. Annabel Angela Chen-Tournoux

8,819, give or take... that’s the number of formal teaching hours contributed in 2022 by DOM faculty to education at McGill, based on self-reported data during the 2023 Annual Performance Review exercise. The new webbased platform for the Performance Review allows us to understand at a very granular level how teaching contributions are distributed across different academic profiles and divisions and provides valuable data to inform recruitment and development strategies. Thank you to all of the faculty who contribute to the teaching mission of the Department, in “formal” and “clinical” settings: please continue to be attentive in tracking your contributions so that we may accurately capture the full scope of our collective effort.

As a means of concretely supporting education leaders in our Department, we implemented a discretionary matching “top-up” program, whereby DOM will match divisional support to specialty program directors, up to a total that is equivalent to the PGME stipend. Eight divisions elected to participate in 2023. We recognize the extreme dedication and hard work of all of our program directors, many of whom have had to manage their programs with significant gaps in dedicated administrative support.

Our McGill-24 campaign raised funds for the DOM Education Scholarship Grants and we had a record number of applications and awardees in 2023, with the following projects receiving funding:

• Faculty perspectives on supervising endocrinology residents in the longitudinal clinic setting (Isabella Albanese, Vanessa Tardio, Diana HJM Dolmans)

• Developing and validating a simulation-based tool for assessment of competence in transthoracic echocardiography (Annabel Chen-Tournoux, Maria Fadous, Maude Peretz-Larochelle, Negareh Mousavi, Lauren Basmadjian, Igal Sebag)

• Trainee and expert perspectives on competency-based training requirements for perioperative medicine training for medical specialists (Lindsey Gerstein, Ning-Zi Sun, Joyce M. W. Moonen-van Loon, Amal Bessisow)

• Evaluating the planetary health knowledge and beliefs of Canadian resident physicians involved in inpatient care (Owen Dan Luo, Rosemarie Vincent, Ning-Zi Sun, Linda Snell)

• Preparedness for and transition to independent practice: An interpretive description of early career Obstetric Medicine physicians’ experiences (Natasha Nathoo, Marjan Govaerts)

In 2023, we held two McGill-wide “Grand” medical grand rounds, with Professor Rory Collins of UK Biobank and Oxford University speaking on “UK Biobank: a unique combination of scale, depth, duration... and accessibility” and Professor Françoise Baylis speaking on “Human Genome Editing: From the First to the Third International Summit.” Narrative Medicine workshops by Emily Churchill-Smith were also offered for faculty and trainees, on Coping Mechanisms, Death and Dying, and Making Mistakes. An illustrious and diverse group joined our cadre of H-KAP fellows, volunteers that continue to share their expertise to advance DOM’s educational mission in retirement: Dr. Nicole Bernard, Dr. Patricia Dobkin, Dr. Rosie Goldstein and Dr. Maida Sewitch.

In keeping with DOM’s academic identity, it is not surprising that education emerged as a priority in the strategic planning exercise undertaken in 2023, with a key aspirational theme for McGill DOM to be a training centre of choice. To achieve this, we will work to ensure

that our core Internal Medicine training program attracts the best candidates and provides the best training in the country; that we ensure a healthy and safe learning/ working environment at all levels; and that our clinicianteachers are valued and respected, and master clinicianteachers are celebrated. More specifically, we will put in place the necessary resources for residents to succeed, whether by providing the most cutting-edge curriculum, language support, or the possibility to pursue dual research and clinical paths. Surveys for residents and clinicianteachers have already identified a first set of priorities to work on in the learning/working environment: coaching/ giving feedback, educational handover, providing clearer paths for academic promotion of clinician-teachers. We are grateful to all who have responded to these surveys and hope that trainees and faculty members will stay engaged in future surveys – your input is invaluable to charting our course as we work to realize our aspirations.

MESSAGE

FROM THE ASSOCIATE CHAIR ADVANCEMENT

Dr. Alain Bitton

In 2023 we successfully initiated the annual Department of Medicine Sam and Sadie Roth Family Visiting Professorship competition. There were many exceptional candidates of high caliber who applied to visit our department and share their expertise. Awards such as these will benefit our department as these should lead to future academic or research collaborations between the visiting professor’s institution and our host division.

McGill’s annual day of giving (McGill24) held in the spring of 2023 raised funds for the McGill Department of Medicine Grants for Scholarship in Medical Education In 2023 we also officially inaugurated the McGill Department of Medicine (DOM) “Rising Star” award with support from the MUHC foundation. The “Rising Star”

program was created in view of promoting the success and productivity of our early career clinician-scientist or medical educator “Rising Stars” by providing salary and operational funding. The next DOM-MUHC “Rising Star” competition will be for 2025. St Mary’s Hospital Center, with the support of its foundation, will be launching its first “Rising Star” competition in the fall of 2024.

The DOM developed a strategic plan based on aspirations with goals and priorities that have been established for the next five years. Philanthropic support from our hospital and university foundations will be instrumental in contributing to our department’s success in achieving these goals.

MESSAGE

FROM THE ASSOCIATE CHAIR QUALITY & SAFETY

Dr.

Emily Gibson McDonald

What an inspiring year for quality and safety in the DOM. Our quality improvement (QI) workforce continues to grow, and our quality awards are becoming more competitive each year! In 2023, we funded studies to improve patient outcomes; for example, Drs. Andrea Blotsky and Gail Goldman at St. Mary’s Hosptal Center will be looking at the implementation of a low-cost diabetes bundle to improve outcomes for diabetic patients admitted to the medical teaching unit, and Dr. Saman Ahmad at the MUHC built a reporting mechanism for Vanessa’s Law into the electronic medical record (reporting serious adverse drug events to Health Canada); we funded awards to improve communication of care; Dr. Michael Goldfarb’s team at the JGH is establishing a program for real-time feedback to improve family engagement in acute cardiovascular care; and we funded projects to improve access to care; for example, Dr. Francois Tournoux (MUHC) is working on new strategies to improve access to echocardiography and Drs. Michael Fein and Michelle Kwok will link the North to the MUHC for allergy video consultation.

Our annual High Value Healthcare Symposium was held on June 6th, 2023, and attendance was high (over 120 participants). High value care is “the best care for the patient, with the best results, delivered at the best price!” This certainly aligns with the DOM strategic plan, especially our key aspirational theme to be effective advocates for the best patient care in resource constrained environments. Each year we present trainee-led clinical research projects in this domain. At the 2023 Symposium our top three abstract presenters were Dr. Reem Farhat (Therapeutic drug monitoring of azathioprine and

tacrolimus in systemic lupus erythematosus pregnancies), Dr. Lindsey Gerstein (Exploring the value of D-dimers for pulmonary embolism diagnosis) and Dr. Kaiyang Li (McGill Adult Atopic Dermatitis Digital Outcomes Study).

In 2024, while we have many exciting developments to look forward to, I’m most excited about setting up a DOM Community of Quality Improvers. Setting up a community has several advantages1: it can 1) SPARK: generate interest in QI, ideas and enthusiasm through information sharing; 2) CONNECT: create links between clinicians and researchers who are leading existing or new initiatives in QI; 3) INFLUENCE: bring together people in the DOM with a shared passion for QI and inspire others; 4) FACILITATE: by sharing intellectual capital and tools in order to take QI initiatives further and strengthen our collective impact; and 5) ACCELERATE: by establishing a community of quality improvers, we can move initiatives along further and faster. Stay tuned for more information about how to join the DOM Community of Quality Improvers. Finally, we were honoured to receive an annual endowment for a visiting lecturer to honour Dr. Sharon Wood-Dauphinee. Dr. Wood-Dauphinee, Professor Emeritus, School of Physical and Occupational Therapy, was a leader and researcher who established new standards in health care excellence by championing quality, collaborative and interdisciplinary care. The first recipient will be announced in June 2024 at the next High Value Healthcare Symposium.

1 Adapted from McDonald et al , Reducing potentially inappropriate polypharmacy at a national and international level: the impact of deprescribing networks . May 2024 Expert Review of Clinical Pharmacology

FROM THE ASSOCIATE CHAIR RESEARCH

Dr. Kevin Schwartzman

Iwas excited and honoured to begin my term as Associate Chair, Research in July 2023. I particularly wish to thank Dr. Susan Kahn, the first holder of this position, who did an outstanding job guiding our research portfolio, paving the way for our continued growth and success. We have much to be proud of, and so many strengths to build on as we move forward. In my new role, I have benefited from strong support from our Research Advisory Committee and our departmental administrative team, notably Alexandra Hauck, Ada Prunescu and Caroline Alcaraz.

In my view, 2023 was the first full post-pandemic “new normal” year. Although we remain mindful of the many lessons learned, and the many adjustments made in the COVID-19 context, our scientists were able to refocus their energies on “non-COVID” aims. Research teams and trainees returned to more consistent, on-site work with all the benefits and synergies that entails. The Department of Medicine launched its strategic plan, with an explicit goal of making our Department the most research-intensive in the country. Fundamental to this goal is the accelerated development and recruitment of highly qualified clinician-scientists, across all divisions, methodologies and geographic sites. We also emphasize enhanced, proactive collaboration between our clinicianand PhD scientists. We began the process of identifying our world class teams – those already at the forefront globally, and those poised to emerge as research leaders.

We also initiated the development of research training pathways that are better integrated within our clinical residency programs, at both the core internal medicine and subspecialty levels. We benefit from committed educational leadership in our residency programs, from McGill’s Clinician-Investigator Program, and from excellent graduate degree programs both within and outside our Department.

Our diversity is a key strength. In the fall 2023 CIHR Project Grant competition, the Department of Medicine accounted for the largest number of applications submitted (23% of all applications from the McGill Faculty of Medicine and Health Sciences), with the second highest success rate (21%) among the major clinical departments. The Department of Medicine also excelled in the FRQ-S salary award competition, with 14 applications funded in spring 2023 out of the 19 submitted (74%). This represents the highest number of applications from any department, and the highest success rate for any department that submitted more than one application. This testifies to the strength of our MD and PhD scientists, including those at the most junior levels, and to the comprehensive mentorship and support we strive to provide.

MESSAGE

Along those lines, the Department held another successful internal funding competition in spring 2023. We received six applications for new CAS MD and PhD scientists, of which three (two MD, one PhD) were funded. I am grateful for the hard work and insightful feedback of our Research Review Committee, and for the continued backing by our MUHC and JGH practice plans and our hospital foundations. This funding correlates directly with our junior colleagues’ continued success in obtaining FRQ-S and Rémunération Recherche support for their research time.

We recognized Dr. Patrick Lawler, an outstanding junior clinician-scientist newly recruited to the Division of Cardiology, as the first recipient of the MUHC Foundation’s Rising Star award – supporting the work of exceptional new clinician-researchers and medical educators.

In 2023, the Department welcomed two new internationally renowned PhD scientists as Canada Excellence Research Chairs: Dr. Dana Small to the Division of Endocrinology and Metabolism, and Dr. Darcy Wagner to the Respiratory Division (Meakins-Christie Laboratories), both based at the RI-MUHC. These sentinel recruitments will catalyze research in the areas of Brain and Metabolism and Lung Regenerative Medicine respectively. The recruitments reflect the outstanding caliber of these new colleagues and the efforts and support of many stakeholders, notably the research leadership within our divisions and research institutes.

Department members were awarded funded to lead major research and training networks, notably in the area of clinical trials.

Finally, the Department of Medicine held another successful Annual Research Symposium in December 2023. Over 140 attendees (hybrid format) learned from a diverse panel of established and emerging researchers, spanning methodologies and substantive areas ranging from iron metabolism to frailty. Over 50 trainees presented their research in poster format, with four selected for oral “abstract slam” presentation. Our keynote speakers were 1)Dr. R. Graham Barr, Hamilton Southworth Professor at Columbia University, who spoke about Cardiopulmonary Failure in COPD; and 2)Dr. Ugochinyere Ukah, incoming Assistant Professor in our Department of Medicine, who spoke about the Identification of Perinatal Factors Associated with Short- and Long-Term Health of Women and Children. We owe many thanks to all our speakers and abstract presenters, and to our DOM administrative team for countless hours of organizational work.

FROM THE ASSOCIATE CHAIR WELLNESS

Dr. Natalie Dayan

As in past DOM reports, I will start by acknowledging the challenges that our faculty face. Across the McGill system, there has been no shortage of obstacles this past year. We have experienced disruptions in academic and clinical work due to strikes, protests, hiring freezes, EMR crashes and, as always, crowding in our ERs. At times, it can feel like external factors affecting our daily lives and our ability to perform optimally are too great to overcome. Yet, all we ever need to do is show up. To listen to that patient in front of us. Lend a helping hand to a colleague in need. Support the growth and development of a mentee. Encourage learners as they step outside their comfort zone. You have each done this, day after day, week after week, despite the innumerable challenges you all face. For that, I am grateful, as you are each a source of inspiration and hope in this chaotic world.

In my own reflection of what this past year has taught me, it is the (re)-discovery of the power of human connection through service. Service – clinical, administrative, or educational – is our currency. Grants, publications, awards or teaching hours are all incredible achievements, but our most precious skill is the ability to transform a life, one interaction at a time.

I want to acknowledge Drs. Patricia Dobkin and Mark Smilovitch for their leadership with Schwartz rounds. Along with our fantastic Wellness Task Force and our new Wellness administrator Dana Ajjaoui, we were able to host six rounds this year. Discussion centred around juggling our many hats, struggling with feelings of

inadequacy, triaging debacles in the ER, setting boundaries in our work and personal lives, talking about death and being cornered by families. The feedback has been positive and attendance and engagement always high (our peak attendance was recorded at 190!). Looking forward to another year of Schwartz discussions – with some in-person sprinkled in the mix.

The DOM is a resilient department: Small sample size and volunteer bias aside, our second Taking the Pulse Wellness survey demonstrated that fewer DOM members reported high burnout (10% vs. 16% in a previous survey) while a similar high proportion experienced moderate to high professional fulfilment (98%). Take-home message: We have what it takes to weather the storm, but continued surveillance and improvements are needed in our environment

Finally, it is important to note that Wellness programs (Schwartz, Mentorship, WeLounge) are meant to support our resilience and demonstrate the leadership’s commitment to the organizations and its individuals’ wellbeing while acknowledging that many stressors are outside our control. DOM leadership is also looking at supporting the work that we do by harmonizing our activities within EMRs and finding creative ways to work with physician extenders. These efforts will go a long way in improving our well-being and allow us to better serve our patients, learners and our community.

MESSAGE

IF YOU JUST LOVE MOVIES ENOUGH, YOU CAN MAKE A GOOD ONE. “

– Quentin Tarantino

”

IN THE SPOTLIGHT:

Dr. Ernesto Schiffrin

This text is a tribute to Ernesto Schiffrin, MD, PhD, in recognition of his remarkable contributions and leadership during his nearly 18-year tenure as the Physician-in-Chief of the Sir Mortimer B. Davis-Jewish General Hospital (JGH) and the Associate Chair of the McGill Department of Medicine as he steps down from these positions.

By Ada Prunescu

He has held, and still holds, many prestigious positions including Director of the Hypertension and Vascular Research Unit at the Lady Davis Institute for Medical Research and Distinguished James McGill Professor. Notably, Dr. Schiffrin’s expertise in hypertension and vascular disease earned him the distinction of being a Tier 1 Canada Research Chair from 2006 to 2019. After many years as Associate Editor of Hypertension, journal of the American Heart Association, since 2016 he has been, Editor-in-Chief of The American Journal of Hypertension. His outstanding achievements led to his being ranked as the 34th Best Scientist in the field of Medicine in Canada for 2023, as well as second at McGill University and 1117th in the world.

EARLY DAYS IN ARGENTINA

Dr. Schiffrin, a native of Buenos Aires, Argentina, completed his medical degree at the University of Buenos Aires. Reflecting on his upbringing, he describes it as an immersive educational experience. “I grew up surrounded by learning,” he recalls. “My mother chaired the English Department at the University’s Teacher’s College, while my father, a pulmonary specialist, chaired the Department of Medicine at a hospital in Buenos Aires. I spoke English from early on because my brother, my sister and I had English governesses, and we all went to English schools. In high school I started going to the Alliance Française in the evenings, and that is how I speak French. My parents and us children traveled a lot, including to Europe and the United States, in the latter, trips my brother and I did as part of exchanges living in my case in Paris for some months and then traveling through England, France and Italy.”

Following his residency training in Internal Medicine and a Research Fellowship at the Instituto de Investigaciones Médicas of the University of Buenos Aires, Dr. Schiffrin decided to make a significant move in 1976 to Montreal, Canada. There, he engaged in research under the direction of Roger Boucher and Jacques Genest Sr. at the Clinical Research Institute of Montreal.

WHY MONTREAL?

Dr. Schiffrin drew inspiration from several professors during his education in Argentina, all of whom had spent extended periods training in North America. One of them was Professor Alberto Taquini, who discovered angiotensin and another was Professor Alfredo Lanari, the Chair of Medicine, who had had extensive experience conducting fundamental and clinical research in the United States.

He was also influenced by Professor Alberto Agrest, an attending physician who Dr. Schiffrin considered to be the most exceptional clinician and diagnostician. Dr. Schiffrin explains that “Not only did all these people make me consider going away to train further, but my mother had studied at Nottingham University in the UK, and at Smith College in Massachusetts, so from a young age I knew I wanted to travel and train in North America.”

Another influential figure was Jacques Genest Sr., MD, the founder and director of the Clinical Research Institute of Montreal (IRCM) in Montreal. Dr. Genest Sr. had visited Buenos Aires and the Institute of Medical Investigation during that time, and it was Professor Agrest who suggested that Dr. Schiffrin pursue a postdoctoral position under him. Furthermore, Schiffrin’s wife had trained as a pediatric endocrinologist under a physician who had been a colleague at Johns Hopkins of the Montreal Children’s Hospital Chief of Endocrinology. The stars seemed to align perfectly as both Dr. Schiffrin and his wife received offers to come to Montreal for a fellowship. Fluent in both French and English, they found the offer to be an ideal fit. “Coming to Montreal seemed ideal,” Dr. Schiffrin reflects, “and it turned out to be the best decision we could make. We have both had offers since to move elsewhere in Canada and the USA, but here we are, 47 years later.”

Over time, Dr. Schiffrin succeeded Dr. Jacques Genest Sr. as the Director of the Medical Research Council of Canada Multidisciplinary Research Group in Hypertension and as the Director of the Hypertension Clinic at the IRCM. Interestingly, 25 years after Dr. Genest Sr. served as Chair of the American Heart Association Hypertension Council, Dr. Schiffrin was elected to the same position. Additionally, 30 years after Dr. Genest Sr. discovered the stimulating effect of angiotensin II on aldosterone secretion, Dr. Schiffrin contributed another significant finding, that natriuretic peptides inhibited this effect. Reflecting on their relationship, Schiffrin noted, “He showed me the way in North American science and politics, and then stayed out of my way. He always said you show the way and then let the person find their way by themselves.”

Dr. Schiffrin adhered closely to Dr. Genest Sr.’s advice as he advanced in his career. He earned a PhD in Experimental Medicine from McGill University in 1980 and directed the Experimental Hypertension Laboratory at the IRCM from 1982 until the end of 2005. In 1991,

he became a Full Professor of Medicine at the University of Montreal. He also worked as an internist at Hôtel-Dieu Hospital, having obtained his FRCPC in Internal Medicine in 1982. From 1990 until the end of 2005, he served as Director of the Multidisciplinary Research Group on Hypertension, funded by the Medical Research Council of Canada and later the Canadian Institutes of Health Research, at the Institute. Additionally, he held the position of Director of the Hypertension Clinic.

In January 2006, Dr. Schiffrin, having been selected Physician-in-Chief of the Sir Mortimer B. Davis-Jewish General Hospital, transferred his clinical and teaching activities to the Jewish General Hospital and became Professor and Associate Chair in the Department of Medicine at McGill. As well, he relocated his laboratory to the Lady Davis Institute for Medical Research.

RESEARCH AND RECOGNITION

Dr. Schiffrin’s main focus has always been centred on research, in addition to his teaching and clinical activity. Due to his continuous efforts and contributions to his field, he has received numerous awards. He holds a particular sense of pride in being honoured with the Order of Canada. Additionally, he cherishes the Excellence Award of the Hypertension Council of the American Heart Association (AHA) and his appointment as a Distinguished Scientist of the AHA in Hypertension and Kidney Disease, as well as Fellow of the Royal Society of Canada. He also received the Bjorn Folkow Award of the European Society of Hypertension, the Robert Tigerstedt Award of the American Society of Hypertension, Margolese National Prize on Heart Disorders, the Prix Galien Recherche Award, and the Franz Volhard Award of the International Society of Hypertension among others. He is also proud of having presided over national and international organizations in the field of hypertension, including the Canadian Society of Hypertension, Hypertension Canada, the AHA Hypertension Council and the International Society of Hypertension among others.

His research revolves around the mechanisms and treatment of high blood pressure, covering everything from genes, molecules and cells to humans. He has authored 631 peer-reviewed publications, several book chapters, and serves as the editor of four published books. Notably, he curated a Compendium on Hypertension (Circulation Research, 2021) focusing on the molecular and clinical aspects of vascular disease and hypertension. With an h-index of 137, his contributions have garnered significant recognition in the scientific community.

“For 47 years I have done basic and clinical research in hypertension and cardiovascular disease since my arrival at IRCM and a McGill PhD program starting in 1976 and I never lost interest. I have been lucky to have been funded for my research uninterruptedly until 2028, which will be 45 years of funding, by the Medical Research Council of Canada and then its successor, CIHR. I have been able to publish highly cited papers, and had great trainees and collaborators, which has contributed to any success I have had and to the persistent interest in the field. I have been very active in professional and scientific societies, and presided over provincial, national and international ones, so it’s been fun and a lot of work. Which is ok when it is fun, and that ensures long-term interest in one’s work and area of expertise,” says Dr. Schiffrin.

On stepping down as Physician-in-Chief of the Jewish General Hospital, Dr. Schiffrin was named Physician-inChief Emeritus by the Board of the hospital. At the time of attribution of this title, Dr. Lawrence Rosenberg, CEO of the West Centre University Health Network of which the Jewish General Hospital is part, said “Since Dr. Schiffrin has contributed immensely to the success of the hospital, we felt something special needed to be done. This honour recognizes the fact that he has played a major role in the history of the hospital.” (JGH News)

WHAT’S NEXT?

Dr. Schiffrin’s CIHR Foundation Grant is coming to an end this year, but he has successfully secured renewed funding from the CIHR for an additional five years. Regarding his future plans, he notes, “I will continue doing the translational and clinical research that I have carried out in the past. I am also involved in developing an international trial on slowing down cognitive decline in the elderly by blood pressure lowering of the population, as well as other clinical trials. I will continue seeing outpatients in the Cardiovascular Prevention Centre at the hospital, mainly managing difficult to control and secondary hypertension as well as other cardiovascular risk factors.”

When asked about advice for aspiring leaders, Dr. Schiffrin emphasizes the importance of empowering department members, promoting fairness and transparency and facing challenges head-on. He encourages leaders to treat everyone equally, demonstrate accountability and avoid shirking responsibility. He also highlights the need for creativity, assertiveness and adaptability, stressing the willingness to change direction if necessary. To become a successful leader, Dr. Schiffrin suggests seeking mentorship or having a role model to emulate. He emphasizes the importance of possessing a strong drive that pushes one forward despite obstacles, setting clear goals and having self-belief.

WHAT ADVICE WOULD YOU GIVE YOUR YOUNGER SELF?

“I would tell “him” to do exactly what I have done, of course there are many things that I could have done better, but I would not want to be anywhere else in the course of my life than where I have been. I have been very fortunate; things have worked as closely to my wishes as they could. We all have ups and downs, but even the downs have been good because they have allowed me to project myself higher from the deepest troughs.”

While Dr. Schiffrin’s departure as a leader in the Department of Medicine will undoubtedly be felt, it will also allow others to step up and to benefit from the opportunity to collaborate with such exceptional talent in the realm of research. In the meantime, we thank Dr. Schiffrin for his dedication, passion and leadership and wish him all the best as he embarks on the next chapter of his career and life.

WORDS FROM COLLABORATORS

Hans Knecht, MD, FRCPC shares: In my first year at McGill, in a joint Editorial of VITAL SIGNS (9/2014), Drs. Ernesto Schiffrin and James Martin highlighted the possible impact of the imposed healthcare reforms on our academic institution, whose goals remain: highest quality of patient care, excellence in teaching and cutting-edge research. This spirit of unconditional commitment who animates the entire Department of Medicine at JGH, well recognized in North America, is intrinsically associated with the personality of Dr. Ernesto Schiffrin, MD, PhD. As a devoted Clinician, passionate and sensitive Teacher, and internationally recognized Researcher, he still found/finds the time to discuss with his Division Chiefs urgent issues needing a backed-up decision. In the turmoil of the COVID pandemic he steered the hospital like a commander in a victorious battle. When I started at the JGH he said to me: “Welcome to the big family.” And how right he was! A well functioning family, respecting every human being, is the foundation of every democratic system. For the DOM at JGH that translates into Respect, Tolerance, Devotion to the Noble Task, Honesty and Academic Freedom, so important for successful Research. In my 10 years at the JGH, these values not only were conserved, they even increased under difficult conditions. That this could and still can happen, is Dr. Ernesto Schiffrin’s merit and legacy.

Mark Lipman, MD, shares:

From the moment he arrived, Ernesto established an exceptional academic reputation at the Jewish General Hospital. Not only did he bring his impressive background in academia and research, but he also brought an unwavering work ethic and a determination to enhance the prominence and influence of the Department of Medicine at the Jewish General Hospital. In this regard, his achievements have far exceeded our expectations.

Foremost, the department has experienced remarkable growth under his leadership. We have attracted exceptional clinicians, esteemed teachers, and accomplished scientists. Ernesto prioritized the protection of the residency training program. He maintained regular meetings with chief residents and attentively addressed their concerns and offered his support. No matter whether the issue was relatively trivial or major, Ernesto consistently stepped up to champion our residents, recognizing them as the backbone of our department. He also played a vital role in navigating us through numerous crises, including the well-known challenge of COVID, as well as other numerous challenges.

Ernesto conceptualized and implemented the highly successful GFT Research Award, which provides incentives and financial support to those pursuing their research goals. He also played a pivotal role in organizing two significant Department of Medicine galas, which raised substantial funds for our endowment. His availability was unparalleled. Whether he was in his office at the JGH, in transit at an airport in Japan or Buenos Aires, or attending a meeting in Europe, if you sent Ernesto an email, you could expect a response within minutes.

Ernesto has displayed unwavering principles, fairness, transparency, and wisdom in his leadership. It has been an honour and privilege to work alongside him. On behalf of all of us, I extend my deepest gratitude to him for his dedicated service and offer heartfelt wishes for good health and continued success in his future endeavors.

Governance, Council and Executive

DOM COUNCIL

DOM Council acts as the Board of Governors or Parliament of DOM approving major policies and broad strategic directions. DOM Council meets every 2 months.

Division Directors

Core Internal Medicine Chief Resident Representative

Core Training Program Director 2 PhD Representatives

3 Observers2 Elected Early Career Representative1

1 Q 2 yearly election held among DOM early career faculty (<4 years since initial University appointment)

2 Leaders of Hospital Divisions in Hospital DOMs whose primary affiliations are in other McGill Departments (e g Medical Genetics, Radiation Oncology)

3 See next page

DOM EXECUTIVE:

DOM Executive meets every 2–3 weeks and is responsible for delivering on the major strategic directions set by DOM Council.

Associate Chair of Medicine

Associate Chair of Research

Associate Chair of Education

Associate Chair of Quality/ Patient Safety

Associate Chair of Wellness

Senior DOM staff Physiciansin-Chief

Associate Chair of Advancement

ROADS? WHERE WE’RE GOING, WE DON’T NEED ROADS. “ ”

– Dr. Emmett Brown, Back to the Future

IN THE SPOTLIGHT: Dr. Dana Small

For double McGill alumna Prof. Dana Small, who holds the Canada Excellence Research Chair in Metabolism and the Brain, the road to high-profile discovery-driven research had some unusual stops along the way.

by Ian McGillis

“I’m a psychologist,” said Dana Small (MScA’98, PhD’01). “My interest is behaviour and brain relationships. In a way, though, I guess I’m a wayward psychologist because I got into metabolism. One thing has led to another.”

Prof. Small was talking last month in an office at The Neuro (Montreal Neurological Institute-Hospital) that she’s been using since being chosen for the Canadian Excellence Research Chair in Brain and Metabolism, a prestigious position that has brought her back to the city of her postgraduate years after two decades at Yale. It’s a cozy nook with enough space for a computer desk, a small table, and her e-bike, which she prefers not to leave outside. She had just returned from a two-day conference in Copenhagen on precision nutrition, a detail that offers a handy indication as to how far she has ranged beyond the standard psychologist’s remit. Hers has indeed been an uncommonly circuitous route, one in which food and metabolism loom large. More of which later.

Small’s story starts on Vancouver Island, where she grew up the only child of a single mother who had epilepsy. Not only was it a situation that engendered a serious sense of responsibility in her at an early age, but it set her on the path she follows to this day.

“When I was 11,” she said, “I wrote a time capsule that said, ‘I want to be a brain scientist.’ That was because of my mom. I would see her lose her consciousness with seizures. I also saw her change with seizure medication. That’s what really drove my interest in the brain. How could she be conscious one minute and not conscious the next? What was going on there? From that time, my holy grail as a scientist has been to understand consciousness.”

The opportunity to put that mission into practice had to wait. First came a youthful adventure that saw the aspiring musician make a leap of faith and move to Montreal. It was to prove a fateful choice.

“I drove across the country with my cat and worldly possessions in a little Toyota Tercel,” she recalled. “My plans were vague but included taking creative writing courses at Concordia and playing flamenco guitar.”

Arriving in the low-rent early 1990s, an era when the day-at-a-time bohemian lifestyle was still possible, Small found herself falling in love with the city and with francophone culture. She quickly became a habituée of the city’s independent music scene, busking on Prince Arthur Street, getting to know future stars Rufus Wainwright and Lhasa de Sela, and writing a music column for the magazine Image (now long defunct). Soon enough, though, a reckoning came.

“That’s right,” she said with a chuckle. “Once in a great while I managed to find a music gig that paid. But I got hungry, literally, because I wasn’t good enough. It was time to come up with a career path.”

To keep a toehold in the science world, Small had volunteered as a research assistant in an animal lab in the psychology department at Concordia. A shortlived idea to combine teaching with travel ended when, through a serendipitous series of events, she met Marilyn Jones-Gotman (MA’71, PhD’75), a professor in the Department of Neurology and Neurosurgery working on epilepsy, who was to become her McGill doctoral advisor and mentor.

Fast forward, beyond the PhD and several years at Yale, and Small was grappling with whether to sign on with the Max Planck Institute in Munich—they had cold-called her during the pandemic asking if she wanted to be a director—when the possibility of the Canada Excellence Research Chair (CERC) came up.

“I loved Yale,” Small stressed. “I had a great time there. My husband (astrophysicist Pieter Van Dokkum) is still on the faculty there, my stepdaughter is an undergraduate there. But the idea of coming back to Canada was always in my mind. CERC meant I could have a whole lot of new opportunities and I could do it at home.”

One of those opportunities, in fact, the chief focus of Small’s CERC time hitherto, involves the metabolism portion of her brain-and-metabolism research.

“Obesity is now the number one risk factor for dementia, apart from age,” she said. “The food environment, and being obese, are somehow damaging the brain. It’s going to take a concerted effort to change this, but I do have hope, I do see traction.”

As it happens, some of Small’s thoughts on food and the food environment are currently reaching a global audience. She appears in the new theatrically released documentary feature Food, Inc. 2, a sequel to the Oscar-nominated 2008 Robert Kenner film.

“I’m in it for about fifteen minutes. My son thinks it’s super cool,” she said with a smile.

A seminal and entirely unanticipated event in Small’s life came in 2017 when, in the course of a routine checkup while she was visiting Montreal, it was discovered that she had thyroid cancer; surgery was performed at Yale in early 2018. The procedure was successful, although it has had lasting after-effects.

“Prior to the surgery I functioned very well on five to six hours of sleep per night,” she said. “I was a workaholic. I ran, on average, about forty miles a week. Afterwards, I have needed anywhere between eight and fourteen hours of sleep, and titrating the thyroid medicine to optimize sleep has been an ongoing ordeal. Finding the energy to run has also been hard. I’m lucky if I run ten miles per week. Needless to say, I miss my thyroid.”

Does the change have day-to-day implications for her work capacity?

“I deal with time management by listening to my own rhythms,” she said. “I work when I’m in the groove and I stop when I’m not. Very few professions allow you to do that, so I’m aware of how fortunate I am. If I had to do the same amount of work, but between nine and five... I don’t think I could do it.”

Asked if she’s someone whose work is portable—if she’s a laptop café person, for example—Small replied with a different take on the very definition of work.

“I work when I’m getting my hair done, I work on the metro. I can work almost any time and any place, and I do. Long walks and long runs are when I get the best ideas. So, ironically, you could say I do my best work when I’m not working. Do I carry a pen and a notebook? No. If it’s worth remembering, I’ll remember it.”

Talking to someone who’s back in Canada after an anticipated two-year stay in the United States stretched to twenty-plus, it’s hard not to ask what salient differences between living and working in the U.S. and here Small may have noted.

“I’ve spent twenty years thinking about that question, and this one: what is the difference between Canadians and Americans? I think it’s down to the fact that, in Canada, you’re told, and you have the feeling, that you are entitled to health and the basics you need to survive, and you can do whatever you want on top of that. In the U.S., you have to work for all those basic things. So Americans are much more competitive. There’s a feeling of insecurity there, and that makes people more focused on making sure they get what they need.”

Presently halfway through the first year of her eightyear CERC tenure, Small is relishing the self-directed freedom and flexibility the position affords her. It’s clear the chance to prioritize her scientific calling is something she intends to make the most of. A hint of her zeal ends up being revealed when she’s asked to name a favourite piece of music, a favourite book, and a hero from history.

“Music? Anything by Lhasa. I get goosebumps just thinking about her songs. I also have to mention Paco de Lucia, the flamenco guitarist. As for a favourite book, I love Russian literature, so I’ll say Pale Fire by Nabokov. And if I could go back in time and talk to one person, it would be da Vinci. I like bicycles, and I also really appreciate the fact that he was interested in human biology and how things work.”

A kindred spirit in arts-and-science affinity, then?

“Yes, that’s it. I actually conceive of science and the arts as very similar. The fundamental thing behind each of them is the same, and that’s discovery. It’s just in different domains. The things that I love about science I find beautiful and profound. The reason I do it is because the feeling of discovery, of knowing something for the first time ever, is like nothing else. It doesn’t happen often, but those moments sustain you.”

THE PURSUIT EXCELLENCE

HOW WE SET OUR GOALS, OUR PLANS AND OUR METRICS

Strategic planning exercises come in all shapes and sizes. Some strategic plans are developed by an individual leader (or small sets of leaders) and then delivered to a community/organization (i.e. top-down approach). We wanted our strategic plan to come from the ground-up, that is we wanted to hear the aspirations of our McGill-wide Department of Medicine community and then develop a plan to deliver on those aspirations.

We created a blank page and participatory exercise that focused on listening to all our members to hear their priorities (or aspirations) and their thoughts on how we might achieve these aspirations. Through a series of open-ended questionnaires, 10 ranking exercises and 10 town halls conducted over 8 months (Oct 2022-June 2023) with excellent representation across sites, career paths and equity seeking groups we ensured that all voices were invited, included and represented in OUR Strategic Plan.

The Strategic Planning Exercise was divided into three phases:

Defining how far we’ve gotten to the destination Defining our Aspirations Tools & Processes: How to Get There 1 2 3

I love working here!

Phase I: Aspirations

Effective Advocates for Patient Care in a Resource Constrained Environment Training Centre of Choice

We conducted open-ended surveys and townhalls asking our community members to provide at least one aspiration for our Department in the next five years. We received over 180 aspirations that we grouped into seven “Aspirational Themes”:

• Effective advocates for the best patient care in resource-constrained environments

• Planetary health

• Most research-intensive DOM in Canada

• Patient & community engagement

• I love working here!

• As diverse as those we serve

• Training centre of choice

After further Delphi ranking survey work, we whittled down to four Key Aspirational Themes (pictured above).

We then surveyed the membership (again!) and identified the top three aspirations within each of the four Key Aspirational Themes, for a total of twelve aspirations. These are detailed below.

Phase II: Tools/Processes

Having identified where we want to go, we then held brainstorming town halls to identify the tools and processes needed

to reach the twelve aspirations. This work will form the focus of our collective efforts over the next five years.

Phase III: Metrics

Finally, we identified one trackable “global” metric for each of the twelve aspirations. These metrics will serve as our indicators along the journey, helping us determine

whether we are making progress, following the correct course, or nearing the fulfillment of our aspirations.

I Love Working Here

1.

ASPIRATION

Where leaders, colleagues and institutions care about me as a person and value and respect my contributions.

TOOLS & PROCESSES

We Lounge (pop-up faculty activities/social gatherings)

Schwartz Rounds

DOM Mentorship program

Leadership development efforts

Coaching programs TBD

METRICS

Annual wellness survey with elements to include a professional fulfilment index and burnout scale

2.

ASPIRATION

Place where digital and other innovations lead to top-notch provider experience & administrative excellence.

TOOLS & PROCESSES

Single provincial EMR

• Ensure good EMR ‘hygiene’

Digital tools that facilitate trainee evaluations, annual review, COI declarations, mandatory training

METRICS

Annual, 2-question survey

3.

ASPIRATION

Where employee growth and development is valued, integrated and paramount to the success of the Department.

TOOLS & PROCESSES

Invest in leadership development for DDs, PDs, and other leaders

Small group and large group team building sessions

Work with administrative leaders to ensure we’re partners in helping team members grow

METRICS

Annual 1-question all-DOM survey

Effective Advocates for Patient Care in a Resource Constrained Environment

1.

ASPIRATION

Delivering/developing digital innovations that improve access to quality care (state of the art EMRs, patientfacing apps, virtual care).

TOOLS & PROCESSES

Get ready/optimize use Province-wide EPIC:

• Coordinated roll out

• Aim to be leaders/super users of EPIC or similar common health record solutions

• End-to-end testing/imaging management

• Patient safety alerts and decision support

• Harness rapid access to data & analytics

• Apply the infrastructure for pragmatic RCTs

Develop a centralized repository of digital solutions and advocate these be patient-centric & decolonized

• Apps for scheduling & appointment

• Patient education

• E-Consultations & Telehealth

Ensure existing and new solutions better meet the needs of our Indigenous populations

METRICS

Digital solutions scorecard (3 questions)

2.

ASPIRATION

Contributing and advocating for solving the current/coming human resource crisis.

TOOLS & PROCESSES

Advocacy training workshops for trainees & Faculty

Bolster advocacy to accelerate training of health care professionals & extenders

Physician Extender programs to mitigate effects of crisis on trainees/Faculty

METRICS

# of DOM member led advocacy initiatives aimed at solving the consequences of health human resources crisis

3.

ASPIRATION

Rendering state of the art diagnostics and therapeutics accessible to all Quebecers.

TOOLS & PROCESSES

Annual surveys of physicians to identify “therapeutic & diagnostic” access gaps

• Choose priority gaps

• Identify advocacy champion & support their campaigns

METRICS

# of DOM member led advocacy initiatives per year focused on addressing gaps in access to therapeutics and diagnostics

Training Centre of Choice

1.

ASPIRATION

Our Core IM programs attract the best candidates and provide the best Core IM training in the country.

TOOLS & PROCESSES

Ensuring that curriculum is cutting edge and at the forefront of advancements, equipping our IM trainees to navigate expected developments in the practice of Internal Medicine

Attract & recruit clinician teacher/educators in:

• POCUS

• Simulation

Dual path clinical/research training stream

Bolster quality & accessibility of med student electives & support French language training

METRICS

CARMS data: Composite rank of all who matched to our CORE program

2.

ASPIRATION

A healthy and safe learning and working environment at all levels.

TOOLS & PROCESSES

Increase physician numbers & physician extenders via MSSS/ hospital level advocacy & internal initiatives

Collect & analyze data based on audit and continuous ‘education quality improvement loops’ Drive culture change towards ‘education through service’ mindset

Develop & implement annual Faculty level learning environment simulations

METRICS

Annual survey of all DOM trainees

3.

ASPIRATION

Our clinician-teachers are valued, respected and master clinician-teachers are celebrated.

TOOLS & PROCESSES

Track teaching contributions

Increase teaching awards (at least 1 UGME award per site and 1 teaching award per residency program per site)

Annual DOM Clinician-Teacher symposium

Measure/report/feedback teaching excellence at the individual Faculty level, Division and DOM aggregate levels (e g . DOM wide overall One45 rating)

• Measure/report and feedback EPA/CAF/ITER completion rates at individual Faculty level to ensure timely and complete trainee feedback

• Advocate for IT solutions to facilitate complete, accurate collection of this data

METRICS

Annual survey of McGill DOM Clinician Teachers

Most Research Intensive DOM in Canada

1.

ASPIRATION

Growing number of clinician-scientists who produce the most impactful research in Canada.

TOOLS & PROCESSES

Dual Path (clinical and research training) Residency/Fellowship streams

Revamp Ex Med Graduate Program to Graduate Program in Clinical and Translational Research

• Clinical- MSc/PhD Digital Innovation and MSc/PhD Clinical Research

Continue Early career CAS and bolster Tenure for Clinician Scientists

METRICS

# of verified Clinician Scientists

# DOM wide publications in top 60 general medical/life sciences journals plus 2-3 sub-specialty

2.

ASPIRATION

PhD scientists and clinicians co-creating in the most translational DOM in Canada.

TOOLS & PROCESSES

Bolster PhD recruitment through CAS research/TT funding opportunities

Align PhD Scientists with Clinical Divisions to maximize multidisciplinary collaboration

“Translational grant” funding opportunity for new collabs between DOM PhD scientists & Clinician Scientists/Investigators

Divisional & MGR “Translational Rounds” with PhD/MD co-presenters

METRICS

# of publications that combine first/senior DOM MD author with DOM PhD scientist (or vice versa)

3.

ASPIRATION

More world-class research teams than any other DOM in Canada (i.e. teams of multi-disciplinary scientists working in a specific area).

TOOLS & PROCESSES

Q4 yearly DOM process to identify:

• Top 3 established world class teams

• Top 3 emerging world class teams

Open & transparent competition with written submissions & presentations by self-identified groups working in ‘area’ led by DOM members

• Structure, Function, Funding & recent & future outputs

Priority to identified/emerging world class teams in areas under DOM’s direct control & where advocacy is essential (e .g . RI & Foundations)

METRICS

# of programs in DOM where 2+ DOM scientists are in top 100 of global reputation indices (Expertscape & Research com)

Throughout the process we heard important, entrenched and well-supported values that characterise McGill DOM today and will only be strengthened tomorrow.

Diversity/ Inclusivity/ Accessibility

Excellence

Patient

Partnership/ Community Outreach

Collaboration

Sustainability

Transparency

Wellness

It is challenging to sum up in a few lines nine months worth of deliberations. However, if we are successful in our efforts in the next five years we will have achieved our goals of ...

“Transforming care locally through effective advocacy, digital innovation and attracting/training the best and brightest. Transforming care globally through world class translational research teams.

Providing a safe and healthy learning/work environment where we value your growth.”

METRICS RELOADED

Year-end Numbers and Summary

DOM BY NUMBERS

307 RESIDENTS

Reference period: July 1, 2023 to June 30, 2024, Academic Year

44 FELLOWS

Reference period: July 1, 2023 to June 30, 2024, Academic Year

29 RETIREMENTS/ DEPARTURES

Reference period: Jan 1, 2023 to Dec 31, 2023, Calendar Year

622  MEDICAL STUDENTS

Reference period: July 1, 2023 to June 30, 2024, Academic Year

326 MCGILL–ADMINISTERED RESEARCH FUNDS

Reference period: As of July 1, 2023

15 PROMOTIONS DOSSIERS

Reference period: Jan 1, 2023 to Dec 31, 2023, Calendar Year

65 POSTDOCTORAL FELLOWS

Reference period: January 1, 2023 to December 31, 2023, Calendar Year

67 NEW FACULTY HIRES

Reference period: Jan 1, 2023 to Dec 31, 2023, Calendar Year

11 ANNUAL EVENTS

Reference period: Jan 1, 2023 to Dec 31, 2023, Calendar Year

FACULTY DISTRIBUTION

DOM is one of the largest departments at McGill. It is a vibrant, diverse and top performing unit, with members who pursue scholarly work that contributes to the advancement of knowledge across a vast spectrum of inquiry and who provide excellent clinical care across a vast swath of the Quebec territory.

469

CORE FULL-TIME FACULTY MDS & PHDS

839

TOTAL # DOM FACULTY MEMBERS

370  PART-TIME FACULTY MDS & PHDS

103  FULL PROFESSORS

197  ASSISTANT PROFESSORS

Core Full-time Part-time

162  ASSOCIATE PROFESSORS

7  FACULTY LECTURERS

186  FACULTY LECTURERS

22  ASSOCIATE PROFESSORS

50  ASSISTANT PROFESSORS

112 ADJUNCT PROFESSORS CLINICAL (MD) AND RESEARCH (PHD) AND AFFILIATESUNRANKED

2023 marked the second year of using a web-based platform to capture information for the Annual Evaluation exercise. The platform provides us with a treasure trove

Full-Time faculty distribution per profile type

17.9%  CLINICIANSCIENTIST

of data to inform and drive our policies, processes and programming. Here is a snippet of what we learned about DOM through use of the platform in 2023.

50.75%  CLINICIANTEACHER

7.9%  CLINICIANINVESTIGATOR

15.6%  SCIENTIST

4.05%  CLINICIANADMINISTRATOR

3.84%  CLINICIANEDUCATOR

Teaching contributions in the DOM

Clinical teaching hours (i.e. 20% of time spent on service/in clinic with clinical trainees) per Faculty member per year

SEX DISTRIBUTION

(FULL-TIME DOM MEMBERS)

This analysis highlights the current state of sex distribution within the DOM compared to the national landscape. By identifying discrepancies in the representation of men and women, the DOM can take targeted actions to promote gender diversity and inclusivity.

DOM Full-Time Faculty Member Sex Distribution

The data shows that the DOM is on par with the national average. Although more work needs to be done, this alignment with national trends indicates that we are on the right path toward achieving a balanced sex distribution within the department.

59%  MEN

41%  WOMEN

Canadian Faculties of Medicine Full-Time Faculty Member Sex Distribution In DOM leadership positions, women are:

31%  OF MUHC DIVISION DIRECTORS 5 OF 16 20%  OF JGH DIVISION DIRECTORS 3 OF 15

17%  OF SMH DIVISION DIRECTORS 2 OF 12

67%  OF DOM ASSOCIATE CHAIRS 4 OF 6

DOM has been sponsoring leadership courses for full-time faculty (through the Canadian Medical Association) and we hope this will result in better representation of women in leadership positions in the DOM

59%

MEN

41%

WOMEN

TOP H-INDICES FOR FULL-TIME FACULTY MEMBERS HOLDING PRIMARY APPOINTMENTS IN THE DOM

Below we use the H-index metric as one measure of academic success of our members. The index is based on the set of the scientist’s most cited papers and the number of citations that they have received in other publications. “The h-index is an author-level metric that measures both the productivity and citation impact of the publications of a scientist or scholar. The h-index correlates with obvious success indicators such as winning the Nobel Prize, being accepted for research fellowships and holding positions at top universities.”[1]

We obtain our H-index report from SciVal – a research analysis tool now being used at McGill – and the SciVal results are considered to be more ‘conservative’ than those gleaned from Google Scholar, for example, since the latter also includes non-peer-reviewed articles and publications. As a result, the H-index from SciVal will be lower than the Google Scholar H-index.

Ref (1) Bornmann, Lutz; Daniel, Hans-Dieter (July 2007). “What do we know about the h-index?”. Journal of the American Society for Information Science and Technology. 58 (9): 1381–1385. doi:10.1002/asi.20609

*Includes faculty with joint appointments to another McGill department, but primary in Medicine.

Top 30 H-indices – 2023

Name

Touyz, Rhian M.

Foulkes, William David

Schiffrin, Ernesto L. 107

Menzies, Robert I. 85

Kahn, Susan R. 84

Goltzman, David 82

Muller, William J. 80

Barkun, Alan N.G. 76

Verma, Atul 75

Bourbeau, Jean C. 72

Rodger, Marc Alan 72

Eisenberg, Mark Jeffrey 70

Pilote, Louise 70

Lakatos, Péter László 69

Piazza, Nicoló 69

Routy, Jean Pierre G. 68

Lin, Rongtuan 67

Bernatsky, Sasha R. 65

Friedrich, Matthias G. 64

Sniderman, Allan David 64

Yang, Xiangjiao 64

Behr, Marcel A. 63

Martin, James G. 63

Benedetti, Andrea L. 62

Richard, Stéphane 62

Sladek, Robert 62

Baron, Murray 60

Olivier, Martin 59

Mayo, Nancy E. 58

Bitton, Alain M. 57

Dendukuri, Nandini 57 Hussain, Sabah N.A. 55

Hutchinson, Tom A. 55

Wolfson, Christina M. 55

Bartlett, Susan J. 54

Förster, Alan John 54

Siegel, Peter Michael 54

Tamblyn, Robyn M. 54

Duque, Gustavo 53

Petrof, Basil J. 53

Daskalopoulou, Stella S. 52

Fantus, Ivan George 52

Fitzcharles, Mary Ann 52

Morais, José A. 52

Filion, Kristian B. 51

Spotlight on Early Career faculty’s research impact

As the H-index increases with years of active publication, we thought it would be of interest to highlight the top 10 H-indices among our recent Early Career faculty (defined for this analysis as hired (whether full-time or part-time) since 2015 and age < 40):

$17,445,231

$49,180,487

*Please take note that the drop is due to the end of the C-Nodes Grant which is now administered by another Federal funded Agency (CADTH)

$51,992,624

$51,274,509

$49,615,684 $47,236,243

Reference periods for both LDI-JGH and RI-MUHC: April 1, 2023 - March 31, 2024

YEAR-OVER-YEAR DOM FRQS SUCCESS

The DOM has a strong tradition of batting at or well above average in FRQS Scientist/Clinician-Scientist applications when compared with the rest of McGill and the rest of the province.

There are many reasons for our success including that we recruit the best/brightest and we support them during the crucial early years of their careers. Of course, the benefits of this success are many and include: 1) protecting our FRQS-funded scientists’ time for research, which is a cornerstone of research productivity that reflects well collectively on the DOM and 2) FRQSfunded DOM members go “hors PEM” allowing us to recruit another faculty member (which leads to a net increase in clinical full-time equivalents). We all win by ensuring/supporting/encouraging DOM FRQS success!

The Department of Medicine excelled in the FRQ-S salary award competition, with 14 applications funded in spring 2023, out of the 19 submitted (74%). This represents the highest number of applications from any department, and the highest success rate for any department that submitted more than one application. This testifies to the strength of our MD and PhD scientists, including those at the most junior levels and to the comprehensive mentorship and support we strive to provide.

DOM performance relative to McGill and relative to Quebec

2023–2024

Source: Research Office, Faculty of Medicine and Health Sciences (Total DOM awards removed from McGill and Quebec totals, to show relative success)

FRQS SALARY AWARDS

(SPRING 2023)

Congratulations to DOM members who were successful in obtaining salary awards for applications submitted in 2022!

What a sweep! 14 Department of Medicine-appointed faculty received awards, for a success rate of 74%. These awards attest to the quality of the support our department/institutional partners provide and to the excellence of the researchers and their research programs.

CHERCHEUR BOURSIER DE MÉRITE

Dr. Dao Nguyen

Dr. Vidal Essebag

CHERCHEUR BOURSIER CLINICIEN SENIOR

Dr. Benjamin Smith

Dr. Evelyne Vinet

Dr. Faiz Ahmad Khan

CHERCHEUR BOURSIER CLINICIEN JUNIOR 2

Dr. Francois Mercier

Dr. Abhinav Sharma

Dr. Nadine Kronfli

CHERCHEUR BOURSIER CLINICIEN JUNIOR 1

Dr. Carolyn Jack

Dr. Chan Gao

Dr. Claire Godard-Sebillotte

Dr. Patrick Lawler

CHERCHEUR BOURSIER JUNIOR 1

Dr. Jonathon Campbell

Dr. Paul Sabatini

NEW FULL-TIME FACULTY APPOINTMENTS 2023

Dr. Alexander Lawandi Infectious Diseases

Dr. Alan Forster Clinical Epidemiology

Dr. Andréanne Lupien Infectious Diseases

Dr. Francois Tournoux Cardiology

FULL PROFESSOR PROMOTIONS

Dr. Atul Verma

Dr. Jonathan Afilalo

Dr. Nitika Pant Pai

Dr. Vicky Tagalakis

Dr. Ilyse Darwish Infectious Diseases

Dr. Jonathan Houle General Internal Medicine

Dr. Nermin Diab Respiratory Medicine

Dr. Patrick Iannattone

General Internal Medicine

Dr. Patrick Lawler Cardiology

Dr. Simon Nigen Dermatology

Dr. Sofia Nene Geriatric Medicine

Dr. Stephanie Larose Endocrinology and Metabolism

PROMOTIONS 2023

ASSOCIATE PROFESSOR PROMOTIONS (FULL-TIME)

Dr. Ali Abualsaud

Dr. Dan Liberman

Dr. Jacqueline Joza

Dr. Michael Goldfarb

Dr. Nadine Kronfli

Dr. Patrick Lawler

Dr. Sapha Barkati

Dr. Thomas Mavrakanas

Dr. Tianyan Chen

ASSISTANT PROFESSOR PROMOTIONS (FULL-TIME)

Dr. Penny Toliopoulos

EDUCATION

The DOM is responsible for 14 residency training programs and for the delivery of the internal medicine component of the undergraduate medical education curriculum.

We are grateful to our Education leaders for their role in the development of the next generation of McGill-trained health care providers, who supervise, guide and mentor approximately 622 medical students, 307 residents and 44 fellows each year.

And we are grateful to our Education leaders for their role in the development of the next generation of McGill-trained scientists, who teach and supervise approximately 350 graduate students for the current year.

Directors of Postgraduate Residency Training Programs (PGME)

CORE INTERNAL MEDICINE (R1-R3)

Dr. Ning-Zi Sun Program Director

Dr. Jonathan How McGill Assistant Program Director

Dr. Maxime Cormier Glen Site Director

Dr. Sana Swaleh MGH Site Director

Dr. Elise Levinoff JGH Site Director

Dr. Samuel Mamane JGH Site Director

ALLERGY & IMMUNOLOGY

Dr. Michael Fein

DERMATOLOGY

CARDIOLOGY

ENDOCRINOLOGY & METABOLISM

GERIATRIC MEDICINE

GASTROENTEROLOGY

HEMATOLOGY

Dr. Negareh Mousavi MUHC Co-Director

Dr. Maude Peretz-Larochelle JGH Co-Director

Dr. Lisa Iannattone

Dr. Vanessa Tardio

Dr. Chiara Saroli Palumbo

Dr. Julia Chabot

Dr. Dan Liberman Assistant Program Director

Dr. Anna Nikonova Co-Director

HEMATOLOGY

Dr. Laura Anne Habib Co-Director

Dr. Patrick Willemot Co-Director

MEDICAL MICROBIOLOGY & INFECTIOUS DISEASES

GENERAL INTERNAL MEDICINE (R4-R5)

NEPHROLOGY

MEDICAL BIOCHEMISTRY

RESPIRATORY MEDICINE

RHEUMATOLOGY

Dr. Makeda Semret

Dr. Brian Gilfix

Dr. Catherine Weber

Dr. Linda Ofiara

Dr. Fares Kalache

Dr. Natasha Nathoo Co-Director

Dr. Stéphanie Cérat Co-Director

Undergraduate Medical Education (UGME) Internal Medicine component

CHAIR, UGME COMMITTEE

CLERKSHIP COURSE SITE DIRECTORS

CLERKSHIP COURSE DIRECTOR

Dr. Tianyan Chen Glen

Dr. Penny Toliopoulos Glen

Dr. Jill Pancer JGH

Dr. Ratna Samanta MGH

Dr. Les Meissner SMH

Dr. Moez Tajdin Gatineau

Dr. Nathalie Saad

Dr. Ratna Samanta

TRANSITION TO CLINICAL PRACTICE (TCP) COURSE DIRECTOR

TCP COURSE SITE DIRECTORS

Dr. Andrea Blotsky

Dr. Andrea Blotsky MUHC

Dr. Nan Zhao JGH

Dr. Les Meissner SMH

Dr. Erica Rubin Gatineau

GRADUATE PROGRAM IN CLINICAL AND TRANSLATIONAL RESEARCH

Dr. Anne-Marie Lauzon Graduate Program Director

PROGRAM UPDATES FROM 2023

In 2023, the Graduate Program in the Division of Experimental Medicine was renamed the Graduate Program in Clinical and Translational Research. The purpose of this rebranding was to ensure the graduate program title reflects the contemporary breadth of the Department of Medicine’s research and vision and encompasses expansions currently under development. The newly named Graduate Program will be organized into three streams; 1) Experimental Medicine (ExMed), 2) Digital Health Innovation, and 3) Clinical Research. The PhD in Digital Health Innovation is in development and will be added to the current MSc in Digital Health Innovation as a separate stream. Development of the Clinical Research stream is anticipated to begin in 2025.

MAJOR OBJECTIVES OF THE GRADUATE PROGRAM IN CLINICAL AND TRANSLATIONAL RESEARCH (EXMED STREAM)

The Graduate Program in Clinical and Translational Research (ExMed stream) joins together 290 professors (clinical and basic science researchers) located in the Research Institutes of the McGill University teaching hospitals (and Institut de recherche clinique de Montréal, IRCM) who supervise graduate students (~350, see details for 2023 below) in one of eight programs. The Graduate Program offers 45 courses ranging from the Biology of Cancer to Quantitative Research Methods.

Elizabeth Fixman Associate Program Director

GOVERNANCE

The Graduate Program in Clinical and Translational Research (ExMed stream) is led by a Graduate Program Director and an Associate Graduate Program Director. An Executive Committee oversees program development and curriculum review and is comprised of members from each Research Institute, both PhDs and MDs, and meets every nine months. An admissions committee comprised of five members evaluates applications on a rolling basis. In 2023, 15 new faculty members (8 MDs and 4 PhDs, 3 MD/PhDs) joined the Graduate Program.

PROGRAMS

In addition to programs above under development, the ExMed stream offers six thesis-based degrees, in addition to the diploma and certificate programs:

• MSc in Experimental Medicine

• MSc in Experimental Medicine, Options in Bioethics, Environment, or Digital Health Innovation

• PhD in Experimental Medicine

• PhD in Experimental Medicine, Option in Environment

• Graduate Diploma in Clinical Research

• Graduate Certificate in Regenerative Medicine

Dr.

STUDENT STIPEND POLICY

As of fall 2022, the Faculty of Medicine and Health Sciences (FMHS) has implemented a harmonized stipend policy where all graduate students receive a base living allowance in addition to tuition and fees. For the 2023-2024 year, the Graduate Program (ExMed stream) received $981,470 in Graduate Excellence Funds (can only be used by direct deposit in students’ accounts) that were used to help off-set the higher tuition paid by out-of-province and international students. A small portion was also used for Graduate Excellence Awards for Canadians and permanent residents.

STUDENT FUNDING

In 2023, ExMed students successfully received funding from external and internal sources. Sixty-one students received external studentships totaling $1,479,580 including four CIHR-Doctoral, 8 CGS-Masters, 11 FRQS Doctoral, and 5 FRQS Masters awards. Of special mention, two PhDs students, Michelle Le and Sarah Maritan, were awarded prestigious Vanier scholarships. Joining two other students who were awarded this honour in 2022 and 2021, ExMed now has four active Vanier scholars. One ExMed student received the Anti-Black Racism Initiative Recruitment award, a new award offered by McGill. An additional 43 students received internal awards and studentships from the FMHS and its associated research institutes totaling $520,000

STUDENT RECRUITMENT

The Graduate Program Discovery Night, organized by the FMHS, was held on October 26, 2023. Over 250 prospective graduate students participated in the remote event, where graduate programs presented the highlights of their graduate programs. The main information session was followed by program-specific zoom drop-in sessions for students to visit.

STUDENT APPLICATIONS

The ExMed admissions committee reviews all completed applications submitted to its graduate programs and criteria of admission are based on applicants meeting minimum cGPA requirements, letters of recommendation, CVs, English language proficiency and personal statements. Only students who have a supervisor are formally accepted. In 2023, the Division welcomed 116 students (23 new students in winter 2023 and 93 new students in fall 2023).

STUDENT NUMBERS

Term Diploma MSc PhD Not registered in Minerva*

2023/01 9 164 163 6 342

*(Leave of Absence, Time Limitation, Did not register)

TRAVEL AWARDS

Using GREAT Travel award funds from Graduate Studies, 21 students received travel awards to present their research at conferences in Canada, the US and abroad in 2023. The GREAT awards provide an important opportunity for students to attend conferences, network with colleagues and learn about cutting-edge research taking place by top scientists in their fields.

STUDENT ORIENTATION

In September 2023 the ExMed Graduate Students’ Society (EMGSS), in collaboration with ExMed, held its new student orientation at the RI-MUHC. Students were provided an overview of the programs, program expectations, funding information and university services available to them. Following orientation, the EMGSS organized an in-person social gathering for all students in the Division.

STUDENT WELLNESS

EMGSS organizes activities throughout the year to foster inclusiveness and to support graduate students in various ways. Activities range from the Buddy Program, stress management workshops to social activities, discussions and peer guidance for thesis writing, and career development. In 2023, they hosted a professional LinkedIn profile photo shoot for ExMed students. The Local Wellness Advisor (LWA) for the graduate students in the FMHS offers one-on-one appointments for students in need of support. The LWA also helps connect students to resources on and off campus and offers wellness workshops in conjunction with the Student Wellness Hub.

SPECIAL EVENTS

The 2023 Annual McGill Biomedical Graduate Conference (AMBGC) was held at the RI-MUHC on March 21, 2023, and was attended by over 200 students and faculty members. The AMBCG included poster sessions, oral presentations and a keynote presentation by Dr. Samuel H. Sternberg, Sloan Research Fellow & Pew Scholar, Department of Biochemistry and Molecular Biophysics, Columbia University.

DOM EVENTS

• 2023 High Value Healthcare Symposium – June 6, 2023

• DOM Annual Awards Soirée – September 14, 2023

• 2023 Research Symposium – December 12, 2023

• World Class Teams Competition – March 26, 2024

WELOUNGE EVENTS

• Guided Wine Tasting – December 14, 2023

• “Take My Hand” by Dolen Perkins Book Club

– February 28, 2024

SCHWARTZ ROUNDS

• MUHC: The Juggling Act: Managing Our Many Roles

– October 17, 2023

• Part of the 5th International Whole Person Care Congress: “When Everything is NOT Enough”

– November 20, 2023

• JGH: Triaging Chaos in the ER: Cultivating Compassion Under Pressure – January 16, 2024

• MUHC: At What Time Does Sunday Become Monday?

– March 25, 2024

• JGH: We Talk To Patients About Death But Who Talks To Us? – May 16, 2024

• SMH: Cornered Caregivers: Navigating Family Dynamics

– May 16, 2024

DOM EVENTS

2023 KUDOS

McGill University Honours and Awards

• Dr. Dan Liberman received the 2023 Medical Student Wellness (MSW) Wellness Award for Teaching.

• Dr. David Dawson inducted into McGill’s Academy of Exemplary Physicians for clinical excellence.

• Dr. Emily McDonald received the Maude Abbott Prize.

• Dr. Erica Stefanie Rubin receives McGill University Transition to Clinical Practice Award.

• Dr. Kristian Filion renewed appointment as a William Dawson Scholar.

• Dr. Mathieu Walker won the Osler Award a second time for his extraordinary teaching.

• Dr. Nancy Mayo received the Distinguished James McGill Professor Award.

• Dr. Nitika Pant Pai received the Haile T. Debas Prize.

• Dr. Patrick Lawler recognized as the inaugural recipient of the Rising Star Award by the McGill Department of Medicine and the MUHC Foundation.

• Dr. Paul Sabatini honored with the William Dawson Scholar Award.

• Dr. Stéphane Beaudoin nominated to 2023-2024 Faculty Honour List for Educational Excellence.

• Dr. Vincent Larouche receives McGill University Transition to Clinical Practice Award.

• Dr. William Foulkes received the Distinguished James McGill Professor Award.

• Dr. William Muller received the Distinguished James McGill Professor Award.

External Honours and Awards

• Dr. Abhinav Sharma selected for the World Heart Federation’s Salim Yusuf Emerging Leaders program.

• Dr. Ana Maria Copaescu receives Canada Gairdner Early Career Investigator Award.

• Dr. Andrey Cybulsky awarded The Kidney Foundation of Canada’s Medal for Research Excellence.

• Dr. Ariane Marelli appointed Scientific Director of CIHR Institute of Circulatory and Respiratory Health.

• Dr. Benjamin Smith and team win the 2023 RI-MUHC Trottier Webster Innovation Award.

• Dr. Cecilia Costiniuk co-chaired the Canadian Conference on HIV/ AIDS Research.

• Dr. David Rosenblatt awarded the Norman Saunders Jacob’s Ladder International Research Prize for his outstanding contribution in the field of genetics research.

• Dr. Dick Menzies appointed the Director of a newly designated Pan American Health Organization/World Health Organization Collaborating Centre for Tuberculosis Research: the McGill International TB Centre.

• Dr. Donald Vinh named a Fellow of the Infectious Diseases Society of America (IDSA).

• Dr. Emily McDonald won Profession Santé Award.

• Dr. Ernesto Schiffrin ranked the 34th top researcher in Canada by Research.com. He was also named Physician-in-Chief Emeritus of the JGH. He received a certificate commemorating his new designation, resulting from a resolution by the CIUSSS’s Board of Directors to honor him as he stepped down after more than 17 years as Chief of the JGH Department of Medicine.

• Dr. Giada Sebastiani represented Canada in the International Delphi Consensus on Metabolic Dysfunction-Associated Fatty Liver Disease and the Risk of Cardiovascular Disease.

• Dr. Gustavo Duque appointed Editor-in-Chief of the Biological Sciences section in The Journals of Gerontology, Series A: Biological Sciences and Medical Sciences.

• Dr. Isabelle Malhamé received Government of Canada funding to improve health care for women and gender-diverse people.

• Dr. Jean Bourbeau named the 2024 Distinguished Lecturer in Respiratory Sciences by the Institute of Circulatory and Respiratory Health (ICRH) of the Canadian Institutes of Health Research (CIHR) and by the Canadian Thoracic Society (CTS).

• Dr. Kaberi Dasgupta received Canadian Diabetes in Pregnancy Study Group (CanDIPs) 2023 Award of Excellence for Research.

• Dr. Martin Olivier’s research collaboration between McGill and Université de Montréal named among top 10 of the year by Québec Science magazine.

• Dr. Maziar Divangahi named the 2024 Mid-Career Lecturer in Respiratory Sciences by the Institute of Circulatory and Respiratory Health (ICRH) of the Canadian Institutes of Health Research (CIHR) and by the Canadian Thoracic Society (CTS).

• Dr. Nathalie Saad and her team were awarded the Grand Prix Hippocrate for the Programme de télé-réadaptation pulmonaire de l’hôpital Mont Sinaï.

• Dr. Nitika Pant Pai appointed a member of Sigma Xi, The Scientific Research Honor Society and Treasurer of IUSTICanada, the newest branch of the International Union Against Sexually Transmitted Infections. She also contributed to the target product profile for readers of rapid diagnostic tests as part of the World Health Organization and Foundation for Innovative New Diagnostics Target Product Profile Development Group.

• Dr. Rita Suri appointed as one of five new members worldwide to the Executive Committee of Kidney Disease: Improving Global Outcomes.

• Dr. Samuel Benaroya honoured by Quebec and receives the Médaille de l’Assemblée nationale.

• Dr. Sapha Barkati and Dr. Marina Klein received the 2023 Fédération des médecins spécialistes du Québec (FMSQ) prize for best research paper.

• Dr. Sasha Bernatsky delivered a podium presentation at the Canadian Rheumatoid Association Scientific Meeting.

• Dr. Simon Rousseau appointed Director of the Canadian Respiratory Research Network.

• Dr. Susan Bartlett received several awards, including the Assembly on Behavioral Science and Health Services Research Lifetime Achievement Award, the Carolyn Thomas Award for Best Scientific Abstract from the Canadian Rheumatology Association/ Arthritis Health Professions Association and the Jeffrey Shiroky Award at the Laurentian Conference of Rheumatology. She was also named presidentelect of the NIH PROMIS Health Organization (PHO).

• Dr. Suzanne Morin received Lifetime Achievement Award from Osteoporosis Canada.

• Dr. Vicky Tagalakis awarded the 2023 Canadian Society of Internal Medicine Award for Distinguished Service in General Internal Medicine.

IN THE SPOTLIGHT: Dr. Darcy Wagner

At McGill University, Darcy Wagner, PhD, recently appointed as a Canada Excellence Research Chair, leads the charge in advancing bioengineered therapies for acute and chronic lung diseases. Her research, centered on advanced 3D bioprinting for precise lung tissue generation, underscores her commitment to addressing acute and chronic lung diseases globally.

By Dana Ajjaoui

The shortage of organ donations is more than a public health crisis for Darcy Wagner, Professor in the departments of Medicine and Biomedical Engineering at McGill’s Faculty of Medicine and Health Sciences; it’s a personal tragedy turned mission. “When I was young, my best friend needed a kidney transplant but he actually died while waiting on the list,” she recounts. “It’s a personal driving force behind what I’ve done for my entire career”

Prof. Wagner’s path to working on lung regeneration was an unexpected one. “I kind of got to lung by accident,” she recalls. Starting in mechanical engineering, she gained essential skills in materials, manufacturing and computational modeling. Later, while working on a PhD in biomedical engineering focused on bone tissue, she got an unexpected opportunity to work on a lung tissue engineering project. Despite never having worked with that organ, she found her calling. “And then I never left lung regeneration.”

This newfound passion was solidified during her postdoc in Vermont where she scaled up the decellularization process to human-sized lungs using pig lungs. “I will never forget, it was the first time we really got cells to survive,” she says. “It took a lot of hard work and creativity to solve the problems we were facing. Sometimes it sounds really crazy, what I’m trying to do, but there are moments when we make real breakthroughs and experiencing this makes you believe that it is possible.”

LEADING THE CHARGE

At McGill, Prof. Wagner now leads cutting-edge research in Lung Regenerative Medicine, addressing acute and chronic lung diseases, which rank as the third and fourth leading causes of death worldwide. Recently appointed as a Canada Excellence Research Chair, her program focuses on refining lung tissue generation through advanced 3D bioprinting techniques.

Prof. Wagner describes tissue engineering as an approach that combines cells with synthetic materials: “We provide a template which we can seed cells onto; this way, the cells come already attached to a tissue substrate. We can generate smaller or larger pieces of tissue this way. Our goal is for it to integrate with the rest of the body, which is much more realistic than trying to bioengineer a whole lung.”

PURSUING ETHICAL INNOVATION

Prof. Wagner expresses a mix of excitement and humility about working in a field with the potential to save lives through regenerative medicine. “It’s exciting, humbling... but it also comes with a big responsibility,” she says. She emphasizes the critical importance of ethical development of new therapies, noting that shortcuts can lead to failure and cost lives.

“There’s so much hope for what these therapies can bring that some people may feel pressure to cut corners. There’s a really high responsibility to do this in the most ethical way.”

Prof. Wagner remains driven and optimistic. “I don’t think there’s anything in life that’s impossible,” she notes. “It’s often how we frame or define what success is.” This perspective fuels her commitment to the rigorous and ethical pursuit of breakthroughs in regenerative medicine.

Prof. Wagner feels privileged to be part of this groundbreaking work, deeply inspired by its impact on patients and families waiting for lung transplants. “I was very much affected by the shortages of donor organs,” she explains. “Knowing that we give hope to patients waiting for lung transplants or their families... that gives hope to patients.”

Looking to the future, Prof. Wagner is excited about the potential to translate research into tangible patient benefits. “Maybe in eight years, we can start conversations about drawing up something that could go into patients, and that’s really exciting.”

INSPIRING THE NEXT GENERATION

Prof. Wagner sees the future of lung regeneration science in the progress and creativity of her students, which she finds deeply inspiring: “It’s really exciting to watch a student not be able to do things or to really struggle. And then to watch them come up with new ideas that you would have never thought of on your own.” She emphasizes the necessity for diversity and change in scientific thinking: “If I’m just replaced, it will just be 100 years of the same type of thinking. The world doesn’t need another one of those people. They need you.”

Thrilled to continue her research at McGill, Prof. Wagner values the significant investments made at the university, in Quebec, and nationally, especially the availability of cutting-edge technologies like advanced microscopes and bioprinters. “These resources will allow me to stay competitive internationally and contribute to McGill by bringing new technologies and equipment to Canada.”

NOTABLE, EXCITING IMPACTFUL

Division Heads & Division and Unit Reports THE THE AND THE

Divisions are the life-blood of an academic department of Medicine. Almost all clinical service, research and teaching are done at the division level. Our department highly values and seeks to support the work done by our divisions and of all members throughout the Department. We hope you enjoy reading these reports as much as we did!

The McGill Department of Medicine comprises 16 clinical divisions, encompassing all aspects of internal medicine and its subspecialties.

CLINICAL ALLERGY & IMMUNOLOGY

Dr. Christos Tsoukas McGill / MUHC

4 Clinician-Teachers

3 Scientists

1 Clinician-Administrator

1 Clinician-Investigator

5 NOTABLE 2023 PUBLICATIONS

(Division or DOM primary member’s name in bold type)

Al-Aubodah, T., Aoudjit, L., Pascale, G., Perinpanayagam, M. A., Langlais, D., Bitzan, M., Samuel, S. M., Piccirillo, C. A., & Takano, T. (2023). The extrafollicular B cell response is a hallmark of childhood idiopathic nephrotic syndrome. Nature Communications, 14, Article 7682. https://doi.org/10.1038/s41467-023-43504-8

Copaescu AM, Vogrin S, James F, Chua KYL, Rose MT, De Luca J, Waldron J, Awad A, Godsell J, Mitri E, Lambros B, Douglas A, Youcef Khoudja R, Isabwe GAC, Genest G, Fein M, Radojicic C, Collier A, Lugar P, Stone C, Ben-Shoshan M, Turner NA, Holmes NE, Phillips EJ, Trubiano JA. (2023) Efficacy of a Clinical Decision Rule to Enable Direct Oral Challenge in Patients With Low-Risk Penicillin Allergy: The PALACE Randomized Clinical Trial. JAMA Intern Med.;e232986

M. Dallmann-Sauer, Y.Z. Xu, A.F. França da Costa,  S. Tao, W. Correa-Macedo, J. Manry, Laurent Abel, Alexandre Alcaïs, Aurélie Cobat, Vinicius M. Fava,  C.M. Probst, M.T. Mira, E. Schurr, Allele-dependent interaction of LRRK2 and NOD2 in leprosy, PLoS Path, 19(3):e1011260, 2023

Genest G, Banjar S, Almasri W, Beauchamp C, Benoit J, Buckett W, Dzineku F, Gold P, Dahan MH, Jamal W, Jacques Kadoch I, Kadour-Peero E, Lapensée L, Miron P, Shaulov T, Sylvestre C, Tulandi T, Mazer BD, Laskin CA, Mahutte N., Immunomodulation for unexplained recurrent implantation failure: where are we now?

Reproduction. 2023 Jan 4;165(2):R39-R60. doi: 10.1530/ REP-22-0150. PMID: 36322478

Florian Stehlin, Rabea Y Khoudja, Ibtihal Al-Otaibi, Faisal ALMuhizi, Michael Fein , Louise Gilbert, Christos Tsoukas, Moshe Ben-Shoshan, Ana-Maria Copaescu, Ghislaine Annie Clarisse Isabwe, J Allergy Clin Immunol Pract. doi: 10.1016/j.jaip.2023.09.037. Epub 2023 Oct 5.

EXCITING RESEARCH IN THE PIPELINE

Project Title: The PALACE Study

Lead: Dr. Ana-Maria Copaescu

Journal: Published in JAMA Internal Med

Penicillin allergy is a widespread public health concern, with one in 10 patients being documented as having a penicillin allergy. However, less than 5% of these patients have their allergy confirmed through specialized testing, and this figure drops to less than 1% for patients with low-risk histories. To verify or delabel a penicillin allergy in adults, current guidelines recommend a three-stage testing process: prick testing, intradermal testing and an oral challenge with penicillin. Although this procedure is safe for most patients, it requires specialized skills and expensive tests typically conducted in an allergist’s office. If penicillin allergy labels could

Dr. Jesse Schwartz JGH

Dr. Jan Schulz SMH

be removed through a direct oral challenge or test dose without preceding skin tests, the process would become simpler and more accessible.

The Penicillin Allergy ClinicAl deCision rulE (PALACE) study is the first international, multicentre, randomized controlled trial to investigate whether a direct oral challenge with penicillin is non-inferior to the current standard of two-stage skin testing followed by an oral challenge in penicillin-allergic patients. Our study demonstrated that a direct penicillin oral challenge is non-inferior to the current routine management involving skin testing before the oral challenge. Additionally, across various secondary safety outcomes, the direct oral penicillin challenge was found to be non-inferior to the current standard of care.

This trial is poised to shift clinical practice, leading to the removal of penicillin allergy labels and improved antibiotic use for outpatients diagnosed with low-risk penicillin allergies. Penicillin allergy removal can be performed safely with a direct oral challenge, eliminating the need for specialist skin testing. Importantly, a direct oral challenge with penicillin is an accessible and cost-effective strategy that physicians can implement worldwide.

Project Title: Study of the extrafollicular B cell response is a hallmark of childhood idiopathic nephrotic syndrome

Leads: Dr. Ciriaco A. Piccirillo & Dr. Tomoko Takano

Journal: Published in Nature Communications

A breakthrough discovery, which revealed the role of the immune system in childhood Idiopathic Nephrotic Syndrome (INS). The study demonstrated that type-I interferon signaling drives the nephrotic B cell response, potentially triggered by respiratory viral infections. This suggests that viral infections might play a role in relapses of INS. The research supports targeting specific B cell subpopulations in treatment strategies, with Rituximab showing promise as a more effective therapeutic option compared to glucocorticoids alone.

Additionally, the study provided crucial insights into the mechanisms of INS, suggesting that autoreactive B cell clones might produce podocytopathic autoantibodies, contributing to the disease. Most importantly, this study uncovered a previously unrecognized role for extrafollicular B cells in childhood INS. It paves the way for improved therapeutic strategies, offering a deeper understanding of the disease’s underlying mechanisms and guiding future therapeutic approaches.

Project Title: Novel therapeutics

Lead: Dr. Danuta Radzioch

In 2023, Dr. Radzioch and her collaborators made a ground-breaking discovery: fenretinide (LAU-7b) can protect against deadly influenza strains by preventing lung damage from excessive inflammation. This exciting new application builds on the drug’s successful use in clinical trials for cystic fibrosis patients. Moreover, LAU-7b is currently part of the ESSOR Long COVID trial, one of the few new therapies in development for this condition, showcasing its broad potential.

Additionally, Dr. Radzioch’s team identified a powerful drug combination for treating metastatic melanoma. Their invention, titled “Immunomodulatory Nanoparticles, Bacterial Membrane Vesicles, Hybrid Particles, And Applications Thereof,” has already caught the eye of investors eager to support further clinical research. The team’s findings have been submitted for publication, marking a potentially significant step forward in cancer treatment.

IMPACTFUL CLINICAL INNOVATION

The Connexion Nordique initiative

Northern Québec’s Region 17 (Nunavik) and Region 18 (Baie-St-James) face significant health care challenges, particularly in allergy care. With patients needing to travel to Montréal for treatment, many miss appointments, losing touch with their cultural context. The Connexion Nordique initiative is making a significant impact by integrating comprehensive virtual health with local allergy visits and forming health care partnerships that provide culturally sensitive care. By empowering local teams to manage allergies and reducing travel burdens, the initiative enhances both patient experience and system efficiency.

To date, the initiative has conducted 70 allergy consultations across three trips to Nunavik and Baie-St-James, built strong local partnerships, and received valuable feedback through surveys. Virtual care clinics launched in June 2024, and the team has already held a successful webinar on Chronic Urticaria with 16 Nunavik physicians. Connexion Nordique is pioneering hybrid virtual care, bridging the gap in allergy treatment for Indigenous communities in Northern Québec. This initiative is set to transform health care access, quality and cultural sensitivity in these remote regions.

CARDIOLOGY

Dr. Atul Verma McGill / MUHC

Dr. Lawrence Rudski JGH

Dr. Mathieu Walker SMH

33 Clinician-Teachers

14 Clinician-Scientists

7 Scientists

5 Clinician-Investigators

3 Clinician-Educators

2 Clinician-Administrators

5 NOTABLE 2023 PUBLICATIONS – MUHC (Division or DOM primary member’s name in bold type)

Akl E, Sniderman AD. Cholesterol, Coronary Calcification, and Cardiovascular Prevention: Lessons We Can Learn From the Western Denmark Heart Registry. Circulation. 2023 Apr 4;147(14):1064-1066. doi: 10.1161/ CIRCULATIONAHA.123.063658. Epub 2023 Apr 3. PMID: 37011071.

Andrade JG, Deyell MW, Macle L, Wells GA, Bennett M, Essebag V, Champagne J, Roux JF, Yung D, Skanes A, Khaykin Y, Morillo C, Jolly U, Novak P, Lockwood E, Amit G, Angaran P, Sapp J, Wardell S, Lauck S, Cadrin-Tourigny J, Kochhäuser S, Verma A; EARLY-AF Investigators. Progression of Atrial Fibrillation after Cryoablation or Drug Therapy. N Engl J Med. 2023 Jan 12;388(2):105-116. doi: 10.1056/NEJMoa2212540. Epub 2022 Nov 7. PMID: 36342178.

Nair GM, Birnie DH, Nery PB, Redpath CJ, Sarrazin JF, Roux JF, Parkash R, Bernier M, Sterns LD, Sapp J, Novak P, Veenhuyzen G, Morillo CA, Singh SM, Sadek MM, Golian M, Klein A, Sturmer M, Chauhan VS, Angaran P, Green MS, Bernick J, Wells GA, Essebag V. Standard vs Augmented Ablation of Paroxysmal Atrial Fibrillation for Reduction of Atrial Fibrillation Recurrence: The AWARE Randomized Clinical Trial. JAMA Cardiol. 2023 May 1;8(5):475-483. doi: 10.1001/jamacardio.2023.0212. PMID: 36947030; PMCID: PMC10034661.

Writing Committee for the REMAP-CAP Investigators; Lawler PR, Derde LPG, van de Veerdonk FL, McVerry BJ, Huang DT, Berry LR, Lorenzi E, van Kimmenade R, Gommans F, Vaduganathan M, Leaf DE, Baron RM, Kim EY, Frankfurter C, Epelman S, Kwan Y, Grieve R, O’Neill S, Sadique Z, Puskarich M, Marshall JC, Higgins AM, Mouncey PR, Rowan KM, Al-Beidh F, Annane D, Arabi YM, Au C, Beane A, van Bentum- Puijk W, Bonten MJM, Bradbury CA, Brunkhorst FM, Burrell A, Buzgau A, Buxton M, Cecconi M, Cheng AC, Cove M, Detry MA, Estcourt LJ, Ezekowitz J, Fitzgerald M, Gattas D, Godoy LC, Goossens H, Haniffa R, Harrison DA, Hills T, Horvat CM, Ichihara N, Lamontagne F, Linstrum KM, McAuley DF, McGlothlin A, McGuinness SP, McQuilten Z, Murthy S, Nichol AD, Owen DRJ, Parke RL, Parker JC, Pollock KM, Reyes LF, Saito H, Santos MS, Saunders CT, Seymour CW, Shankar-Hari M, Singh V, Turgeon AF, Turner AM, Zarychanski R, Green C, Lewis RJ, Angus DC, Berry S, Gordon AC, McArthur CJ, Webb SA. Effect of Angiotensin-Converting Enzyme Inhibitor and Angiotensin Receptor Blocker Initiation on Organ Support-Free Days in Patients Hospitalized With COVID-19: A Randomized Clinical Trial. JAMA. 2023 Apr 11;329(14):1183-1196. doi: 10.1001/jama.2023.4480. Erratum in: JAMA. 2023 Dec 26;330(24):2398. PMID: 37039790; PMCID: PMC10326520.

Luu JM, Malhotra P, Cook-Wiens G, Pepine CJ, Handberg EM, Reis SE, Reichek N, Bittner V, Wei J, Kelsey SF, Sailaja Marpuri R, Sopko G, Bairey Merz CN. Long- Term Adverse Outcomes in Black Women With Ischemia and No Obstructive Coronary Artery Disease: A Study of the WISE (Women’s Ischemia Syndrome Evaluation) Cohort. Circulation. 2023 Feb 14;147(7):617-619. doi: 10.1161/CIRCULATIONAHA.122.063466. Epub 2023 Feb 13. PMID: 36780383; PMCID: PMC10290895.

EXCITING RESEARCH IN THE PIPELINE – MUHC

Project Title: DECIDE-CV Clinic

Lead: Dr. Abhinav Sharma

Dr. Abhinav Sharma won the Department of Medicine Emerging World Class Teams project for their DECIDE CV clinic. This multidisciplinary clinic allows for a “one stop” shop for high-risk patients with diabetes or other vascular risk factors. The clinic is run out of the CIM and is a platform for numerous clinical trials evaluating time to starting and compliance guideline directed medical therapy.

Project Title: Recherche clinique et épidémiologique sur le traitement pharmacologique et technologique (par dispositifs implantables et interventions électrophysiologiques) des arythmies cardiaques

Investigator: Dr. Vidal Essebag

Dr. Vidal Essebag won his FRQS Merite Award last year in recognition of his past and ongoing clinical trial research in cardiac electrophysiology. He is currently the co-PI on a CIHR funded grant of $1.6 million for the AWARE 2 trial evaluating if additional non-pulmonary vein triggers need to be ablated on top of pulmonary vein isolation for paroxysmal atrial fibrillation.

Project Title: Low-dose docetaxel: potential anti-atherosclerosis drug

Leads: Dr. Jacques Genest & Dr. Iulia Iatan

Dr. Jacques Genest won a grant in aid with Dr. Iulia Iatan in Internal Medicine from the Heart and Stroke Foundation of Canada. Grant-in-aid 2024-27. Genest J, Choi HY, Iatan I. Low-dose docetaxel: potential anti-atherosclerosis drug. This will be an exciting project looking into novel drug discovery for treatment of hyperlipidemia.

IMPACTFUL CLINICAL INNOVATION – MUHC

First program in Quebec to treat patients with new Pulsed Field Ablation (PFA)

Our cardiac electrophysiology program has always been at the centre of new technological developments. This year, we became the first program in Quebec to treat patients with new “Pulsed Field Ablation (PFA)” which uses electrical pulses instead of thermal energies to ablate triggers for atrial fibrillation inside the heart. The main advantage of this non-thermal technology is safety. There is no risk to accidentally causing collateral damage to structures close to the heart such as the esophagus or phrenic nerve. The procedures are also more reproducible which leads to procedural efficiency. Our team has been working on several clinical trials, which have helped to bring this technology to fruition, and we continue to work on newer versions of PFA technologies that will continue to revolutionize our field.

CARDIOLOGY

(cont’d)

5 NOTABLE 2023 PUBLICATIONS - JGH

(Division or DOM primary member’s name in bold type)

Fountotos R, Ahmad F, Bharaj N, Munir H, Marsala J, Rudski LG, Goldfarb M, Afilalo J.Multicomponent intervention for frail and pre-frail older adults with acute cardiovascular conditions: The TARGET-EFT randomized clinical trial. J Am Geriatr Soc. 2023 May;71(5):1406-1415. doi: 10.1111/jgs.18228.

Epub 2023 Jan 16

Goldfarb M. Family Engagement in Critical Care Cardiology: A Guide for Clinicians. Can J Cardiol. 2023 Apr;39(4):562-565. doi: 10.1016/j.cjca.2022.10.001. Epub 2022 Oct 7.PMID: 36216036

Prell C, Hébert-Losier A, Filion KB, Reynier P, Eisenberg MJ Evaluating the impact of varying expired carbon monoxide thresholds on smoking relapse identification: insights from the E3 trial on e-cigarette efficacy for smoking cessation. BMJ Open. 2023 Oct 13;13(10):e071099. doi: 10.1136/bmjopen-2022-071099.PMID: 37832989 Free PMC article. Clinical Trial.

Klein AL, Wang TKM, Cremer PC, Abbate A, Adler Y, Asher C, Brucato A, Chetrit M, Hoit B, Jellis CL, Kwon DH, LeWinter M, Lin D, Luis SA, Mardigyan V, Oh JK, Ordovas KG, Rodriugez ER, Schenone AL, Tan CD, Weber B, Imazio M Pericardial Diseases: International Position Statement on New Concepts and Advances in Multimodality Cardiac Imaging. JACC Cardiovasc Imaging. 2024 Aug;17(8):937-988. doi: 10.1016/j. jcmg.2024.04.010.PMID: 39111992

Nair P, Chen-Tournoux A, Almufleh AS, Blissett S, Ducas R, Fine NM, Johri AM, Kushneriuk D, Ramer S, Sanfilippo A, Thibodeau-Jarry N, Yu E, Bewick D, Burwash IG, Chow CM, Cooley H, De S, Douflé G, Fagan SM, Henri C, Jassal DS, Jelic T, Lee D, Leipsic J, Leong-Poi H, Luksun W, Mulloy AJ, Mulvagh S, Nesbitt G, Promislow S, Sebag IA, Tran DTT, Tsang TSM 2023 CCS/ CSE Standards for Physician Training and Maintenance of Competence in Adult Echocardiography: Executive Summary.Can J Cardiol. 2023 Oct;39(10):1302-1306. doi: 10.1016/j.cjca.2023.06.418. Epub 2023 Jun 22.PMID: 37355231

EXCITING RESEARCH IN THE PIPELINE – JGH

Project Title: Family Engagement in the ICU

Investigator: Dr. Michael Goldfarb (PI)

Funding: CIHR, Canadian Critical Care Trials Group, Department of Medicine Scholarly Quality Grant, McGill Nursing Collaborative Research Funding

1. Recruitment and Retention Strategies for Family Members in the Intensive Care Unit: A study within a trial randomized factorial design

2. Real time feedback to improve family engagement –NGAGE Trial

3. Virtual Family Participation in ICU Rounds

Project Title: Frailty in Acute Cardiac Care

Investigator: Dr. Jonathan Afilalo (PI)

Funding: CIHR, Center for Aging and Brain Health

Innovation Spark Grant, AWS Artificial Intelligence Award, JGH Foundation

1. Opportunistic Markers of Frailty in Acute Cardiac Care

2. Coreslicer: Deep Learning of CT Images for Frailty Assessment in Cardiac Care

3. HealthStat: Enriching home-based vital signs for virtual care in older adults

4. Canadian Heart Failure Transformation Alliance

5. Bioportal – phenotyping study

Project Title: Smoking Cessation in Coronary Artery Disease

Investigator: Dr. Mark Eisenberg (PI)

Funding: CIHR

1. ASAP Trial – Aggressive Smoking Cessation Therapy Among People at Elevated Cardiovascular Risk

IMPACTFUL CLINICAL INNOVATION – JGH Pericardial Diseases

The JGH’s Division of Cardiology embarked on the creation of a pericardial diseases clinic several years ago. The Clinic has grown organically into the 3rd largest such clinic in North America. It offers a full complement of services from the routine to biologics, and has a percutaneous and surgical program. We receive patients from all regions of Quebec for consultation and urgent procedures. Dr. Mardigyan served as a guest editor for a focussed edition of the Canadian Journal of Cardiology and co-authored a number of manuscripts with both world leaders as well as McGill Cardiology trainees. One important manuscript detailed how to set up a pericardial diseases program, and our model is now being translated to other sites in Canada, including the IUCPQ (Quebec Heart and Lung Institute), with the JGH training one of their Fellows. The JGH believes that our successes can and must be translated to other centres to the benefit of so many more.

CLINICAL EPIDEMIOLOGY

10 Scientists

2 Clinician-Scientists

5 NOTABLE 2023 PUBLICATIONS

(Division or DOM primary member’s name in bold type)

Douros A, Ante Z, Suissa S, Brassard P. Common vaccines and the risk of incident dementia: a population-based cohort study. Journal of Infectious Diseases. 2023 May 29;227(11):1227-1236. doi: 10.1093/infdis/ jiac484.PMID: 36542511.

Suissa S, Dell’Aniello S, Renoux C. The Prevalent New-user Design for Studies With no Active Comparator: The Example of Statins and Cancer. Epidemiology. 2023 Sep 1;34(5):681-689.

Abrahami D, Pradhan R, Yin H, Yanofsky R, McDonald EG, Bitton A, Azoulay L. Proton Pump Inhibitors and the Risk of Inflammatory Bowel Disease: Population-Based Cohort Study. Gut 2023 Jul;72(7):1288-1295.

Dimakos J, Cui Y, Platt RW, Renoux C, Filion KB, Douros A. Concomitant Use of Sulfonylureas and B-Blockers and the Risk of Severe Hypoglycemia Among Patients With Type 2 Diabetes: A Population-Based Cohort Study. Diabetes Care. 2023 Feb 1;46(2):377-383. doi:10.2337/ dc22-1584

Tamblyn R., Girard N., Hanley J., Habib B., Mota A., Khan K M., Ardern C L. Ranking versus rating in peer review of research grant applications. PLoS ONE 18(10): e0292302 https://doi.org/10.1371/journal. pone.0292306 5 October 2023.

EXCITING RESEARCH IN THE PIPELINE

Project Title: Developing Statistical Tools and Visualization Methods for Understanding Heterogeneity in Distributed Networks: Applications to COVID-19 and Diabetes

Investigator: Dr. Robert Platt (PI)

Funding: CIHR Project Grant - $485,774

Date: 2023-2026

Scientists at the Canadian Observational Network for Drug Effect Studies (CNODES) have created ways to combine results from separate Canadian provinces, the United Kingdom, and the United States to rapidly assess the safety and effectiveness of drugs while minimizing the risk of accidentally exposing patient data or jeopardizing patient privacy. Because each province differs from the others, the United States, and the United Kingdom, the best research strategies (as well as the overall safety and effectiveness of drugs) can be very different as well. In 2022, these differences are larger than ever thanks to the ongoing COVID-19 pandemic substantially altering the types of drugs patients start taking and whether they attend in-person office visits with their providers. Currently, however, there are very few ways to understand, document and communicate these differences. This research project aims to develop new ways for researchers to understand, interpret and communicate differences in how parts of networks like CNODES (or other studies involving multiple populations) decide which patients receive what treatment, differences in rates of important

Dr. Robyn Tamblyn MUHC

Dr. Samy Suissa JGH

risk factors and health outcomes, and the extent to differences between populations change research findings and alter treatment effectiveness. These new tools will be tested on data from the United Kingdom’s Clinical Practice Research Datalink (CPRD), treating six geographic areas as if they were each contributing data to a distributed network like CNODES. Finally, the tools will be used to study 2019, 2020, 2021, and 2022 data from the CPRD, Ontario, and British Columbia to understand how the timing of lockdowns and other pandemic prevention measures impacted whether patients initiated various drug treatments for high blood pressure, diabetes, and depression, as well as the frequency of various important health outcomes.

Project Title: Canadian Network for Observational Drug Effect Studies (CNODES)

Investigators: Drs. Robert Platt & Samy Suissa (PI)

Funding: Canadian Agency for Drugs and Technologies in Health (CADTH) - (Post-market drug evaluation (PMDE) Program) - $9,088,000

Date: 2022-2025

CNODES is a pan-Canadian network of over 100 scientists from all provinces working to ensure the safety and effectiveness of drugs for Canadians, previously funded by CIHR and currently by CADTH. The coordinating centre is located at the Jewish General Hospital’s Lady Davis Institute. CNODES is led by Drs Robert Platt and Samy Suissa, with collaborating hubs in seven provinces. Our studies examine widely used drugs and are carried out in response to queries from our government partners, including Health Canada and provincial stakeholders. The results of these studies have important public health implications and have been published in highly ranked peer-reviewed international journals, benefitting not only Canadians, but patients worldwide. The data sources used by CNODES include population databases from seven Canadian provinces (Alberta, British Columbia, Manitoba, Nova Scotia, Ontario, Saskatchewan and Quebec) and two international databases (UK CPRD and US MarketScan). CNODES also works in collaboration with the FDA Sentinel Initiative group in rapid-response studies, using a common data model (CDM) for standard analyses, as well as with the European Medicines Agency.

Project Title: Canadian consortium of clinical trial training (CANTRAIN) platform: enhancing career preparedness in RCT research targeting different audiences across the continuum

Investigator: Dr. Kristian Filion (PI)

Funding: CIHR - Project Grant - $11,317,323

Date: 2022-2025

The CANadian Consortium of Clinical Trial TRAINing platform is a pan-Canadian endeavour that is funded by the Canadian Institutes of Health Research whose overarching goals are to enhance national clinical research capability and quality in clinical research education and good clinical practice though accredited training programs and hands-on practice with interactive activities. CANTRAIN integrates 21st century clinical & regulatory affairs experience relative to gender-balanced patients, people with disabilities, their families, policy-makers, communicators, communities and real-world operations. The CIHR application included over 90 applicants from nine different provinces, with the coordinating centre located at the Research Institute of the McGill University Health Centre. CANTRAIN includes four streams: 1) Clinical Research Professionals; 2) Graduate Trainees; 3) Trialists; and 4) Community and Government Partners. The Trialist Stream, which is targeting clinician-scientists, principal investigators, and clinical fellows and residents, is being led by Professor Kristian Filion of the Lady Davis Institute and McGill University. This e-learning platform will be leveraged to develop a Graduate Certificate in Clinical Trials in the School of Population and Global Health at McGill University.

IMPACTFUL CLINICAL INNOVATION

The Digital Health Innovation “Crown Jewel” Course: Developing Digital Innovations for Health Impact (EXMED630)

Dr. Nitika Pant Pai

EXMED630 is a health design thinking course that not only teaches innovative thinking mindsets but also provides practical knowledge on applying design thinking principles to solve real-world health and clinical problems. By the end of this course, students will have the skills to identify health issues, apply innovative and design thinking principles, and develop digital prototypes and cutting-edge solutions that can be directly

applied in their respective fields. Students observe these problems in their health environments. The students learn the basics of innovative thinking and then proceed to learn design thinking. In nine weeks, they grow from the idea and develop a prototype. The course is focused on digital prototypes, wearables, and new cutting-edge solutions.

EXAMPLES OF INNOVATIONS CREATED BY STUDENTS IN THE COURSE

1. Allez up 2022 Map for navigation inside hospital premises. Dobson Cup finalist 2023. It has already secured funding from the Jewish General Hospital and is being used there. They are expanding within hospitals in Montreal and Canada.

2. De-prescribing software for seniors 2022. The student team won an award for innovation.

3. A Complete rehab program for post op care for lung transplant recipients 2022. Led by a surgery fellow from Japan.

4. A digital program to alert patients for hypoglycemia 2022. This program is made of a wearable, app and dashboard is aimed to alert Type 2 DM patients to episodes of nocturnal hypoglycemia and to send prompts to take action to prevent falls and complications and show up for care.

5. ER Triage time 2023. Innovation that is very relevant for Quebec. It allows a rapid triage of all patients before admission, stages them in advance and directs them to the best care facility. Led by a Swiss physician Fellow, and working to secure funding to take it to fruition.

6. A Post Surgical care program for all residents of surgical units 2022. This was led by an Israeli physician Fellow aimed to develop a surgical rehab program for patients.

7. Map to live 2023 Hub for homeless. This innovation is for housing and health services for homeless populations in Montreal. Dobson Cup finalist 2024.

8. Wearable bracelet for medical information 2023. Innovation for seniors to help transfer and exchange their medical information to their doctors with ease upon admission in any ER.

9. Mental Health counselling Chatbot 2023 Group created an app that provides targeted counselling for anxiety and directs young adults to the counsellors in the city.

10. Frailty tool kit 2023. Low resource setting tool kit to dx frailty. For front line health care workers training and dx and access to physiotherapy. This kit was developed for low-income countries. Has secured funding to scale and is in use in under resourced settings.

11. A diabetes care program for Indigenous populations in Quebec 2023. From access to screening to treatment and retention in care.

REFLECTIONS FROM STUDENTS

“I wanted to express my heartfelt gratitude for delivering such an outstanding course. Your ability to captivate our interest in the subject matter is truly commendable.”

“Thanks to your instruction, I find myself contemplating a career shift towards this field.”

“In just a short period, you not only elucidated the intricacies of digital innovation but also motivated us to excel in creating prototypes. Your dedication to teaching and inspiring others is evident in every aspect of the course.”

“I wanted to express my gratitude for an exceptional semester! Attending your classes has been an enriching experience, and I have gained invaluable knowledge from your expertise.”

“Your passion for teaching is truly inspiring, and your dedication to helping students succeed has made a significant impact on me. I genuinely appreciate the effort you put into creating an engaging learning environment.”

DERMATOLOGY

Dr. Ivan Litvinov McGill/MUHC

5 Clinician-Teachers

4 Clinician-Scientists

1 Clinician-Educator

1 Clinician-Investigator

5 NOTABLE 2023 PUBLICATIONS

(Division or DOM primary member’s name in bold type)

Prognostic factors for the development of acneiform eruptions in patients on epidermal growth factor receptor inhibitors. Bierbrier R, D’Aguanno K, Kasymjanova G, Dell’Aniello S, Agulnik J, Pehr K. J Am Acad Dermatol. 2023 Apr;88(4):869-870. doi: 10.1016/j. jaad.2022.10.005.

Gene-Environment Analyses in a UK Biobank Skin Cancer Cohort Identifies Important SNPs in DNA Repair Genes That May Help Prognosticate Disease Risk. Jeremian R, Xie P, Fotovati M, Lefrançois P,  Litvinov IV. Cancer Epidemiol Biomarkers Prev. 2023 Nov 1;32(11):1599-1607.

NOD2 Agonism Counter-Regulates Human Type 2 T Cell Functions in Peripheral Blood Mononuclear Cell Cultures: Implications for Atopic Dermatitis. Gimenez-Rivera VA, Patel H, Dupuy FP, Allakhverdi Z, Bouchard C, Madrenas J, Bissonnette R, Piccirillo CA, Jack C. Biomolecules. 2023 Feb 15;13(2):369. doi: 10.3390/biom13020369.

Dr. Robin Billick JGH

Skin disorders and interstitial lung disease: Part II-The spectrum of cutaneous diseases with lung disease association. Ouchene L, Muntyanu A, Assayag D, Veilleux È, Abril A, Ferrara G, Yacyshyn E, Pineau CA, O’Brien E, Baron M, Osman M, Gniadecki R, Netchiporouk E. J Am Acad Dermatol. 2023 Apr;88(4):767-782.

Teledermatology in remote Indigenous populations: Lessons learned and paths to explore, zn experience from Canada (Québec) and Australia. Nguyen A, Zhu CK, O’Brien E. Digit Health. 2023 Nov 29; 9:20552076231217813. doi: 10.1177/20552076231217813. eCollection 2023 Jan-Dec.

EXCITING RESEARCH IN THE PIPELINE

Project Title: Acquiring a Nanopore long-read sequencer to characterize novel transcripts in heavily-mutated skin cancer tumors from patients

Investigator: Dr. Philippe Lefrançois

Funding: Canada Foundation for Innovation (CFI)$272,000

Dr. Philippe Lefrançois received a $272,000 Canada Foundation for Innovation (CFI) grant to acquire a Nanopore long-read sequencer to characterize novel transcripts in heavily-mutated skin cancer tumors from patients.

Project Title: Host Pathogen Determinants of Remission in Adult Atopic Dermatitis

Investigator: Dr. Carolyn Jack

Funding: Fonds de recherche du Québec (FRQS)Clinical Research Scholar - Junior 1 - $196,363

Date: 2024-2027

Dr. Carolyn Jack was recognized by the Fonds de recherche du Québec (FRQS) as a Clinical Research Scholar - Junior 1 (grant duration 2024/1 - 2027/12), with a total funding of $196,363 for her research, “Host Pathogen Determinants of Remission in Adult Atopic Dermatitis.”

Project Title: Fostering the establishment of culturally sensitive dermatologic care in northern Quebec

Investigator: Dr. Ivan Litvinov

Funding: LEO Foundation - 3,074,290 DKK

Dr. Ivan Litvinov received a grant from the LEO Foundation in the amount of 3,074,290 DKK over 3 years for implementation of a science research project to foster establishment of culturally sensitive dermatologic care in northern Quebec.

IMPACTFUL CLINICAL INNOVATION

Establishment of the first Canadian specialized oncogenodermatology clinic at the Montreal General Hospital

Co-lead by Dr. Elena Netchiporouk (Dermatologist) and Dr. William Foulkes (Medical Genetics)

This clinic assesses 30-35 patients for genetic testing, family screening and provides a detailed management plan to treating physicians for cancer predisposition syndromes, genetically inherited skin cancers and other genodermatoses. This clinic is linked to clinical registry and biobank, and since inception assembled one of the largest (worldwide) cohorts of hereditary leiomyoma renal cell carcinoma patients.

ENDOCRINOLOGY & METABOLISM

23 Clinician-Teachers

12 Scientists

6 Clinician-Scientists

3 Clinician-Investigators

1 Clinician-Administrator

1 Clinician-Educator

5 NOTABLE 2023 PUBLICATIONS

(Division or DOM primary member’s name in bold type)

Y Chen, T Lu, U Pettersson-Kymmer, ID Stewart, G Butler-Laporte, T Nakanishi, A Cerani, KYH Liang, S Yoshiji, JDS Willett, CY Su, P Raina, CMT Greenwood, Y Farjoun, V Forgetta, C Langenberg, S Zhou, C Ohlsson, JB Richards. Genomic atlas of the plasma metabolome prioritizes metabolites implicated in human diseases. Nature Genetics [IF: 41.4]. 2023 Jan12;55(1):44-53. doi: 10.1038/s41588-022-01270-1.

S Yoshiji, G Butler-Laporte, T Lu, J Willett, CY Su, T Nakanishi, D Morrison, Y Chen, K Liang, M Hultström, Y Ilboudo, Z Afrasiabi, S Lan, N Duggan, C DeLuca, M Vaezi, C Tselios, X Xue, M Bouab, F Shi, L Laurent, H Münter, M Afilalo, J Afilalo, V Mooser, N Timpson, H Zeberg, S Zhou, V Forgetta, Y Farjoun , JB Richards. (2023) Proteome-wide Mendelian randomization implicates nephronectin as an actionable mediator of the effect of obesity on COVID-19 severity. Nat Metab [IF: 7.745] (2023).  2023 Feb;5(2):248-264 .doi: 10.1038/ s42255-023-00742-w. Epub 2023 Feb 20.

Specific heterozygous variants in MGP (matrix Gla Protein) lead to endoplasmic reticulum stress and cause spondyloepiphyseal dysplasia. Gourgas O, Lemire G, Eaton AJ, Alshahrani S, Duker AL, Li J, Carroll RS, Mackenzie S, Nikkel SM; Care4Rare Canada Consortium; Bober MB, Boycott KM, Murshed M. Nat Commun. 2023 Nov 3;14(1):7054. doi: 10.1038/ s41467-023-41651-6.

In this study a new type of skeletal dysplasia caused by a previously unreported mutation in matrix Gla protein (MGP) gene was discovered. Using cell culture and genetically modified mouse models, it was demonstrated that this mutation impairs the secretion of MGP by the growth plate chondrocytes leading to its accumulation in the endoplasmic reticulum (ER). ER stress markers were upregulated with a marked increase of apoptotic cells in the growth plates. Thus the skeletal phenotypes in the patients might have been caused by the apoptosis-related loss of the differentiating chondrocytes in the growth plates and also by the premature calcification of the growth plate matrix due to the absence of MGP that normally prevents abnormal mineralization of the cartilaginous tissues.

Wu N, Wang SJ, Brazeau AS, Chan D, Mussa J, Nakhla M, Elkeraby M, Ell M, Prevost M, Lepine L, Panagiotopoulos C, Mukerji G, Butalia S, Henderson M, Da Costa D, Rahme E, Dasgupta K. Supporting and Incentivizing Peer Leaders for an Internet-Based Private Peer Community for Youths With Type 1 Diabetes: Social Network and Directed Content Analysis. J Med Internet Res. 2023 Dec 12;25:e48267. doi: 10.2196/48267. PMID: 38085568; PMCID: PMC10751631.

Dr. George Fantus McGill/MUHC

Dr. Mark Trifiro JGH

Dr. Les Meissner SMH

This was a social network and thematic analysis of a type 1 diabetes Canada wide peer group we created. We demonstrated that the peer leaders whom we fostered were the central members of the network and the discussions on the network provided the social support that was the rationale for network creation. The work was funded by the CIHR and Diabetes Canada for which I was PI. We are in dialogue with Diabetes Canada to embed this network in their activities. The first author was my MSc epidemiology student.

Zhou S,. Sosina OA, Bovijn J, Laurent L, Sharma1V, Akbari P, Forgetta V, Jiang L, Kosmicki J A, Banerjee N, Morris J A, Oerton E, Jones M, LeBlanc M G, Regeneron Genetics Center, IdoneV, Overton J, Reid J G, Cantor M, Abecasis G R, Goltzman D, Greenwood C M. T, Langenberg C, Baras A, Economides A N, Ferreira M A. R, Hatsel S, Ohlsson C, J., Richards B, Lotta L A. Converging evidence from exome sequencing and common variants implicates target genes for osteoporosis Nat Genet. 2023 Aug;55(8):1277-1287

Whittier DE, Samelson E J, Hannan M T, Burt L A, Hanley D, Biver E, Szulc P, Sornay-Rendu E, Merle B, Chapurlat R, Lespessailles E, Wong A K, Goltzman D, Khosla S, Ferrari S, Bouxsein M L, Kiel DP, Boyd S K. A fracture risk assessment tool for high resolution peripheral quantitative computed tomography J Bone Miner Res 2023. 38, 9 :1234–1244.

Younes N, Larose S, Bourdeau I, Therasse E, Lacroix A. Role of Adrenal Vein Sampling in Guiding Surgical Decision in Primary Aldosteronism. Exp Clin Endocrinol Diabetes. 2023 Aug;131(7-08):418-434. doi: 10.1055/a2106-4663. Epub 2023 Aug 11. PMID: 37567230.

Goltzman D. Approach to Hypercalcemia. In: Feingold KR, Anawalt B, Blackman MR, Boyce A, Chrousos G, Corpas E, de Herder WW, Dhatariya K, Dungan K, Hofland J, Kalra S, Kaltsas G, Kapoor N, Koch C, Kopp P, Korbonits M, Kovacs CS, Kuohung W, Laferrère B, Levy M, McGee EA, McLachlan R, New M, Purnell J, Sahay R, Shah AS, Singer F, Sperling MA, Stratakis CA, Trence DL, Wilson DP, editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2023 Apr 17.

EXCITING RESEARCH IN THE PIPELINE

Project Title: Diabetes Canada: A dyadic coping strategy to enhance step prescription effects in type 2 diabetes: a Bayesian adaptive basket randomized controlled trial (Partner Step T2D)

Investigator: Dr. Kaberi Dasgupta (PI)

Date: 2023-2026

This builds on our previous work showing couple concordance for type 2 diabetes (BMC Medicine, 2014) and gestational diabetes as a predictor for diabetes in partners (Diabetes Care, 2014, American Journal of Epi, 2017). In this trial, we are testing a couple counselling communication intervention combined with step count goals compared to step count goals alone, in terms of physical activity and A1C impacts in type 2 diabetes.

Project Title: Understanding how a novel mutation in matrix Gla protein causes skeletal anomalies

Investigator: Dr. Monzur Murshed (PI)

Funding: Canadian Institutes of Health Research (CIHR)Project Grant - $612,000

Date: 2024-2029

This CIHR grant will be used to investigate the cell type-specific effects of the mutated protein in the developing skeleton and to examine whether pharmacologic interventions preventing ER stress or gene therapy to correct the point mutation can prevent the skeletal abnormalities seen in our mouse model.

Project Title: Anti-parathyroid hormone-related protein (PTHrP) monoclonal antibodies against metastatic cancer

Investigator: Dr. Richard Kremer (PI)

Funding: Canadian Institutes of Health Research (CIHR) - Project Grant - $665,550

Dates: 2023-2026

Project Title: Co-administration of Semaglutide and insulin via an automated dual-hormone artificial pancreas system to avoid carbohydrate counting in type 1 diabetes

Investigator: Dr. Michael Tsoukas (PI)

Funding: National Institute of Health - $950,000

Dates: 2023-2026

Project Title: The association between denosumab and the risk of atypical femoral fractures in osteoporosis management

Investigator: Dr. Oriana Yu (PA)

Funding: Canadian Institutes of Health Research (CIHR) - $179,776

Dates: 2024-2026

Project Title: The BioPortal: A Collection of Biospecimens and Annotated Data for Research Purposes

Investigator: Dr. John Brent Richards (PI)

Funding: Hoffmann-La Roche Limited - $2,198,415.89

Dates: 2023-2030

IMPACTFUL CLINICAL INNOVATION

Revolutionary new platform using a microfluidic technology to capture circulating tumor cells (CTCs)

Drs. Richard Kremer & Catalin Mihalcioiu

Richard Kremer with colleague Catalin Mihalcioiu established a revolutionary new platform using a microfluidic technology to capture circulating tumor cells (CTCs) from the blood circulation of melanoma patients as to examine cancer progression in real time.

Mihalcioiu C, Li J, Badescu D, Camirand A, Kremer N, Bertos N, Omeroglu A, Sebag M, Di Battista J, Park M, Ragoussis J, Kremer R. Improved platform for breast cancer circulating tumor cell enrichment and characterization with next-generation sequencing technology. Am J Cancer Res. 2023 Jan 15;13(1):25-44. PMID: 36777514; PMCID: PMC9906071.

Established rapid access clinic slots for patients from ER at Glen and MGH.

Dr. Mark Sherman

These are designed for patients that can be discharged home safely but need medical attention within 2-3 days but can avoid an ER consult. The ER MDs can book directly without the need to triage or call consult service. This accelerates ER discharge rates and saves time. Examples are new or poorly controlled type 2 diabetes, moderate hyper- or hypothyroidism. This initiative of the Division was led by Dr. Mark Sherman.

Dr. Alain Bitton

McGill/MUHC

GASTROENTEROLOGY & HEPATOLOGY

23 Clinician-Teachers

4 Clinician-Investigators

2 Clinician-Scientists

1 Clinician-Administrator

1 Scientist

5 NOTABLE 2023 PUBLICATIONS

(Division or DOM primary member’s name in bold type)

Cinque F, Saeed S, Kablawi D, Ballesteros LR, Elgretli W, Moodie EM, Price C, Monteith K, Cooper C, Walmsley S, Pick N, Murray MCM, Cox J, Kronfli N, Costiniuk C, De Pokomandy A, Routy JP, Lebouche B, Klein MB, Sebastiani G. The role of fatty liver in the epidemic of advanced chronic liver disease among people with HIV: protocol for the Canadian LIVEHIV multicentre, prospective, cohort study. BMJ Open 2023 Aug 22;13(8)

Chen YI, Sahai A, Donatelli G, Lam E, Forbes N, Mosko J, Paquin SC, Donnellan F, Chatterjee A, Telford J, Miller C, Desilets E, Sandha G, Kenshil S, Mohamed R, May G, Gan I, Barkun J, Calo N, Nawawi A, Friedman G, Cohen A, Maniere T, Chaudhury P, Metrakos P, Zogopoulos G, Bessissow A, Khalil JA, Baffis V, Waschke K, Parent J, Soulellis C, Khashab M, Kunda R, Geraci O, Martel M, Schwartzman K, Fiore JF Jr, Rahme E, Barkun A.

Endoscopic Ultrasound-Guided Biliary Drainage of First Intent With a Lumen-Apposing Metal Stent vs Endoscopic Retrograde Cholangiopancreatography in Malignant Distal Biliary Obstruction: A Multicenter Randomized Controlled Study (ELEMENT Trial). Gastroenterology. 2023 Nov;165(5):1249-1261.

Benmassaoud A*, Macias A*, Delamarre A, Corma-Gomez A, Guaraldi G, Milic J, Rockstroh JK, Van Bremen K, Tsochatzis E, Mulay A, Price J, Garvey LJ, Lemoine M, Kablawi D, Lebouche B, Klein MB, Ballesteros LR, Boesecke C, Schepis F, Bhagani S, Cooke G, Berzigotti A, Hirose K, Pineda JA, Ramanakumar AV, De-Ledinghen V, Saeed S*, Sebastiani G*. (2023). Prognostic value of non-invasive scores based on liver stiffness measurement, spleen diameter and platelets in HIV-infected patients. Liver International. 43(7):1427-1439.

Hansen-Barkun C, Martel M, Douketis J, Abraham NS, Liederman Z, Kaplovitch E, Schulman S, Spyropoulos AC, Majid A, Barkun AN. Periprocedural Management of Patients With Atrial Fibrillation Receiving a Direct Oral Anticoagulant Undergoing a Digestive Endoscopy. Am J Gastroenterol. 2023 May 1;118(5):812-819

Afif W, Arasaradnam RP, Abreu MT, Danese S, Sandborn WJ, Miao Y, Zhang H, Panaccione R, Hisamatsu T, Scherl EJ, Leong RW, Rowbotham DS, Peyrin-Biroulet L, Sands BE, Marano C. Efficacy and Safety of Ustekinumab for Ulcerative Colitis Through 4 Years: Final Results of the UNIFI Long-Term Maintenance Study. Am J Gastroenterol. 2024 Jan 26. doi: 10.14309/ajg.0000000000002621. Online ahead of print.

EXCITING RESEARCH IN THE PIPELINE

Project Title: Fatty Liver, Fibrosis and Inflammatory Bowel Disease: A Triple Threat

Investigator: Dr. Giada Sebastiani (PI)

Funding: Crohn’s Colitis Canada - $375,000

Date: 2023-2026

Dr. Albert Cohen JGH

Dr. Gaetano Morelli SMH

Dr. Karen Matouk SMH

Fatty liver disease may affect one in three people living with IBD and can lead to liver fibrosis and end-stage liver complications, such as cirrhosis and liver cancer. This research aims to determine the risk of liver disease among those with IBD and to develop clinical guidelines to improve care for those affected. The study will follow 680 Crohn’s or colitis patients for three years to determine their risk of liver fibrosis, identify any IBD-related factors for the development of fatty liver disease and determine the effect of fatty liver disease on health care system use.

Project Title: A novel through-the-scope exchangeable double balloon catheter to guide endoscopic bypass: a practice-changing technology in the management of malignant gastric outlet obstruction

Investigator: Dr. Yen I Chen (PI)

Funding: Canadian Institutes of Health Research (CIHR) - Project Grant - $451,350

Date: 2024-2026

Malignant gastric outlet obstruction (MGOO) is a common and morbid complication of gastric and pancreatic cancers. Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is an emerging technique for bypassing tumor-related blockages using a specialized stent. Level I evidence demonstrates EUS-GE’s superiority over the current standard of care of duodenal stenting, with enhanced clinical success, diet tolerance, and <5% MGOO recurrence. The technical complexity of EUS-GE, however, has limited its dissemination. The aim of this proposal is to bring to commercialization an assist device to greatly facilitate EUS-GE; thereby, enhancing clinical adoption. This would be a practice-changing technology in the management of malignant gastric outlet obstruction.

Project Title: Can a prehabilitation program with a maintenance phase prevent worsening of frailty in patients with cirrhosis undergoing liver transplantation? A feasibility trial

Investigator: Dr. Amine Benmassaoud (PI)

Funding: Canadian Association for the Study of Liver$50,000

Date: 2021-2023

Prehabilitation in patients with cirrhosis awaiting liver transplantation

Patients with cirrhosis awaiting liver transplantation are often malnourished and frail. Prehabilitation, combining exercise training, nutritional optimization, and psychological support, provides a multipronged approach to patients awaiting surgery. These interventions may improve preoperative physical strength and lead to a reduction in postoperative complications, and health care utilization costs. This clinical trial is an open-label feasibility study where patients with cirrhosis awaiting liver transplantation are enrolled in a prehabilitation program. This study, in collaboration with the Preoperative Program at the MGH, is composed of a 4-week induction phase followed by a 20-week maintenance phase. The impact of the prehabilitation on frailty and nutritional status will be evaluated.

IMPACTFUL CLINICAL RESEARCH INNOVATION

Locoregional treatment of pancreatic cancer

Dr. Corey Miller

To address the pressing need for safe and effective locoregional treatment for pancreatic cancer, different anticancer technologies, administered by endoscopic ultrasound (EUS), are being explored. Dr. Miller leads the first-in-human clinical study of Alpha DaRTTM (Alpha Tau Medical), a novel method of delivering alpha radiation to solid tumors using intratumoral placement of wires impregnated with radium-224 sources. Another technology uses the Magnetodrones™ (Starpax Biopharma),  bacteria drones conjugated with chemotherapy and controlled magnetically by the Starpax PolarTrak™ to distribute and contain the drug in a tumour. Having developed the EUS technique for intratumoral injection, Dr. Miller will lead the pancreatic cancer axis of a phase 1/2 study of this modality. Dr. Miller’s team has also partnered with experts in computer science, engineering, and physics at McGill and Concordia University to develop a first of its kind 3D navigation system using augmented reality in order to improve the accuracy of  Alpha DaRTTM insertion and optimize tumour coverage using EUS.

GENERAL INTERNAL MEDICINE

42 Clinician-Teachers

11 Clinician-Scientists

4 Clinician-Investigators

3 Clinician-Educators

2 Clinician-Administrators

5 NOTABLE 2023 PUBLICATIONS

(Division or DOM primary member’s name in bold type)

McDonald EG, Aggrey G, Aslan AT, Casias M, CortesPenfield N, Dong MQD, Egbert S, Footer B, Isler B, King M, Maximos M, Wuerz TC, Azim AA, Alza-Arcila J, Bai AD, Blyth M, Boyles T, Caceres J, Clark D, Davar K, Denholm JT, Forrest G, Ghanem B, Hagel S, Hanretty A, Hamilton F, Jent P, Kang M, Kludjian G, Lahey T, Lapin J, Lee R, Li T, Mehta D, Moore J, Mowrer C, Ouellet G, Reece R, Ryder JH, Sanctuaire A, Sanders JM, Stoner BJ, So JM, Tessier JF, Tirupathi R, Tong SYC, Wald-Dickler N, Yassin A, Yen C, Spellberg B, Lee TC. Guidelines for Diagnosis and Management of Infective Endocarditis in Adults: A WikiGuidelines Group Consensus Statement. JAMA Network Open. 2023 Jul 3;6(7). doi: 10.1001/jamanetworkopen.2023.26366.

Morin SN, Feldman S, Funnell L, Giangregorio L, Kim S, McDonald-Blumer H, Santesso N, Ridout R, Ward W, Ashe MC, Bardai Z, Bartely J, Binkley N, Burrell S, Butt D, Cadarette SM, Cheung AM, Chilibeck P, Dunn S, Falk

J, Frame H, Gittings W, Hayes K, Holmes C, Ioannidis G, Jaglal SB, Josse R, Khan AA, McIntyre V, Nash L, Ngem A, Papaioannou A, Ponzano M, Rodrigues I, Thabane L, Thomas CA, Tile L, Wark J for the Osteoporosis Canada 2023 Guideline Update Group. Clinical Practice Guideline for management of osteoporosis and fracture prevention in Canada; 2023 update. Canadian Medical Association Journal 2023 October 10;195: E1333-48. doi: 10.1503/ cmaj.221647

Blackman A(*), Ukah UV, Platt RW, Meng X, Shapiro GD, Malhamé I, Ray JG, Lisonkova S, El-Chaar D, Dayan N Severe Maternal Morbidity and Mental Health Hospitalizations or Emergency Department Visits. JAMA Netw Open April 2024; 7(4):e247983. doi: 10.1001/jamanetworkopen.2024.7983

Vallipuram T, Schwartz BC, Yang SS, Jayaraman D, Dial S. External validation of the ISARIC 4C Mortality Score to predict in-hospital mortality among patients with COVID-19 in a Canadian intensive care unit: a single-centre historical cohort study. Can J Anaesth. 2023 Aug;70(8):1362-1370.

Cafaro T, Allwood M, McIntyre WF, Park LJ, Daza J, Ofori SN, Ke Wang M, Borges FK, Conen D, Marcucci M, Healey JS, Whitlock RP, Lamy A, Belley-Côté EP, Spence JD, McGillion M, Devereaux PJ. Landiolol for the prevention of postoperative atrial fibrillation after cardiac surgery: a systematic review and meta-analysis. Can J Anaesth. 2023 Nov;70(11):1828-1838. doi: 10.1007/s12630-02302586-0. Epub 2023 Nov 2. PMID: 37917331; PMCID: PMC10656308.

Dr. Michelle Elizov McGill

Dr. Suzanne Morin MUHC

Dr. Rubin Becker JGH

Dr. Gail Goldman SMH

EXCITING RESEARCH IN THE PIPELINE

Project Title: Deteriorating Patient App

Investigator: Dr. Jeffrey G Wiseman

Funding: Seed grant from the DOM

Deteriorating patient app funded by a seed grant from the DOM is now being prepared and tested for use by the entire undergraduate class in the next 2025 ERRAD (Early Recognition of and Response to Acute Deterioration in hospitalized patients) 4th year Medical Undergraduate course. Similar learners are also preparing it for use from the Universite d’Angers in France.

Project Title: The promotions process as an act of power: An institutional ethnography of faculties of medicine in Canada.

Investigator: Dr. Beth-Ann Cummings (CO-Applicant)

PI: Soklaridis S. Co-Applicants: Constance LeBlanc, Anna Macleod, Beth-Ann Cummings, Teresa Chan, Boluwaji Ogunyemi, Mala Joneja, Erin Cameron, Maria Hubinette, Brett Schrewe, Lyn Sonnenberg, David Keegan, Ming-Ka Chan, Marilyn Baetz, Ayelet Kuper, Cynthia R. Whitehead, Kinnon MacKinnon. Collaborators: Babar Haroon, Rachel Kronick, Saleem Razack, Catherine Cervin, Diane M. Lougheed, Jane Philpott, Christina St-Onge, Julien Poitras, Melanie Lewis, Jayna Holroyd-Leduc, Aliya Kassam, Valerie H. Taylor, Sara Israels, Jerry Maniate, Sharon Whiting, Pier Bryden, Gillian Hawker, Patricia Houston, Morag C. Paton, Pooitsing Andrea Lum, Suzan Schneeweiss. The promotions process as an act of power: An institutional ethnography of faculties of medicine in Canada. Social Sciences and Humanities Research Council (SSHRC) Partnership Development.

Project Title: Diabetes in a time of COVID: Understanding impacts of material deprivation and other social factors on direct and indirect pandemic effects on persons with diabetes

Investigator: Dr. Kaberi Dasgupta

Funding: Canadian Institutes of Health Research (CIHR)

IMPACTFUL CLINICAL INNOVATION

The MGH Medical Day Hospital (MDH) opened its doors on January 15, 2024.

Dr. Patrizia Zanelli

The MGH Medical Day Hospital (MDH), under the leadership of the MUHC GIM Division and spearheaded by Dr. Patrizia Zanelli, opened its doors on January 15, 2024. The overarching goal of the MGH MDH is to improve flow at the MUHC by taking over the care of patients who require rapid and more intense care that can be provided in the outpatient setting (and not requiring immediate emergency department care) and/ or who need closer monitoring following discharge from in-patient units or emergency department. This project has been the culmination of much work and reflects the Division of GIM’s ongoing role in leading and supporting innovations in care.

GERIATRIC MEDICINE

14 Clinician-Teachers

3 Clinician-Scientists

1 Clinician-Administrator

1 Scientist

5 NOTABLE 2023 PUBLICATIONS

(Division or DOM primary member’s name in bold type)

Gustavo Duque, Ben Kirk, Hidenori Arai Strong muscles lead to strong bones: The connection between osteoporosis, sarcopenia, falls and fractures. Bone. 2023 Aug:173:116789. doi: 10.1016/j.bone.2023.116789

Nene, S., Rauch, M., Belanger, D., Bennett, R., Berry, G., Saad, N. Morin, S. N. Personalized Telehealth: Redesigning Complex Care Delivery for the 65+ During the COVID Pandemic: a Survey of Patients, Caregivers, and Healthcare Providers. Can Geriatrics J. 2023; 26(1), 150-175. doi: 10.5770/cgj.26.641

Arsenault-Lapierre G, Bui TX, Le Berre M, Bergman H, Vedel I. Rural and urban differences in quality of dementia care of persons with dementia and caregivers across all domains: a systematic review. BMC Health Serv Res. 2023 Jan 31;23(1):102. doi: 10.1186/s12913-023-09100-8

Boutros GH, Vita S, Faust A, Hodge ET, Mastandrea C, Balram S, Lagacé JC, St-Martin P, Divsalar ND, Sadeghian F, Liu-Ambrose T, Babler AP, Dionne IJ, Duschesne S, Hughson R, Kontulainen S, Theo O, Morais JA. Impact of 14 days of bed rest in older adults and an exercise

countermeasure on body composition, muscle strength and cardiovascular function: Canadian Space Agency standard measures. Gerontology 2023;69(11):1284-1294. doi: 10.1159/000534063.

Sourial N, Beauchet O, Kruglova K, Robins S, Margo-Dermer E, Quesnel-Vallée A, Launay C, Dassieu L, Godard-Sebillotte C, Karunananthan S, Puzhko S, Holyoke P, Tchouaket E. Profiles of socially isolated community-dwelling older adults during the COVID-19 pandemic: A latent class analysis. Maturitas. 2023 May;171:1-6. doi: 10.1016/j.maturitas.2023.02.002.

EXCITING RESEARCH IN THE PIPELINE

Project Title: PUPPY Study - Problems Coordinating and Accessing Primary Care for Attached and Unattached Patients Exacerbated during the COVID 19 Pandemic Year: A longitudinal Mixed Methods Study with Rapid Reporting and Planning for the Road Ahead

Investigators: Drs. Godard-Sebillotte C (PI), Breton M (Co-I), Cossette B (Co-I), Green ME (Co-I), Isenor J (Co-I), Marshall EG (Co-I), Mathews M (Co-I)

Funding: Canadian Institutes of Health Research (CIHR) - $407,552

Date: 2020-2025

Objectives of the Project: The difficulties regarding coordination and accessibility to primary care are notorious and their exacerbation during Covid could serve as means to learn about roadblocks and potential ways of solving this aspect of the health care system.

Dr. José Morais McGill / MUHC

Dr. Ruby Friedman JGH

Dr. Shek Hong Fung SMH

Project Title: The CARE Grant: Virtual Reality based Music Intervention in an Acute Geriatric Setting

Investigators: Drs. Julia Chabot (Co-PI) and Harmehr Sekhon (Co-PI)

Funding: Care Grant from St. Mary’s Research Centre$30,000

Date: 2023-2025

Objectives of the Project: To study the virtual realitybased music intervention in the acute geriatrics setting. This study is undertaken with the collaboration of SAMS (Société pour les arts en milieu de santé).

Project Title: Ketone bodies as therapeutic agents to reduce the harmful effects of bed rest on muscle mass and metabolic health in older adults

Investigators: Drs. Churchward-Venne T (Nominated PI), Chevalier S (Co-PI), Gouspillou, G (Co-PI), Morais, JA (Co-PI)

Funding: Canadian Institutes of Health Research (CIHR) - $420,751

Date: 2020-2023

Objectives of the Project: Bed rest is a common feature of many clinical environments such as hospitals and extended care facilities. However, the inactivity associated with bed rest leads to the loss of muscle mass, strength and functional capacity that can manifest into a decreased quality of life and a higher risk of morbidity and mortality. The study intends to increase ketone bodies via exogenous ketone supplements to mitigate disuse-induced declines in skeletal muscle mass, protein synthesis, and insulin sensitivity in older adults during short-term bed rest.

IMPACTFUL CLINICAL INNOVATION

Motion Visual Reality

Falls are a frequent health problem encountered in older adults with consequences such as fractures, hospital admissions and mortality (the 6th leading cause in the geriatric population). Balance deficits are known for contributing to falls. Thanks to the support of the MGH Foundation, the Division has acquired the new Motion Visual Reality® instrument, a dynamic posturography and rehabilitation platform. It is used to assist in the diagnosis of gait and balance impairment of patients referred to the MUHC-MGH Falls and Bone Health Clinic. It is also employed by our physiotherapist of MGH-Geriatric Day Hospital in high-risk patients, which should accelerate their rehabilitation process.

HEMATOLOGY

14 Clinician-Teachers

5 Clinician-Scientists

4 Clinician-Administrators

4 Clinician-Investigators

2 Clinician-Educators

2 Scientists

5 NOTABLE 2023 PUBLICATIONS

(Division or DOM primary member’s name in bold type)

Assouline S, Gasiorek J, Bergeron J, Lambert C, CuljkovicKraljacic B, Cocolakis E, Zakaria, C, Szlachtycz D, Yee K, Borden KLB. Molecular targeting of the UDP-glucuronosyltransferase enzymes in high-eukaryotic translation initiation factor 4E refractory/relapsed acute myeloid leukemia patients: a randomized phase II trial of vismodegib, ribavirin with or without decitabine. Haematologica. 2023 Nov 1;108(11):2946-2958.

Korsos V, Ali A, Malagon T, Khosrow-Khavar F, Thomas D, Sirhan S, Davison K, Assouline S, Cassis C. End of life in haematology: quality of life predictors - retrospective cohort study. BMJ Support Palliat Care. 2023 Apr 17:

Côté J, LeBlanc R, Mian H, Chu MP, McCurdy A, Masih-Khan E, Su J, Jimenez-Zepeda VH, Song K, Louzada M, White D, Sebag M, Reiman A, Stakiw J, Kotb R, Bergstrom D, Aslam M, Kaedbey R, Venner CP, Gul E, Reece D. Real-world results of autologous stem cell transplantation in newly diagnosed multiple myeloma: a report from the Canadian Myeloma Research Group database. Blood Cancer J. 2023 Sep 5;13(1):137.

Neault M, Lebert-Ghali CÉ, Fournier M, Capdevielle C, Garfinkle EAR, Obermayer A, Cotton A, Boulay K, Sawchyn C, St-Amand S, Nguyen KH, Assaf B, Mercier FE, Delisle JS, DrobetskyEA, Hulea L, Shaw TI, Zuber J, Gruber TA, Melichar HJ, Mallette FA. CBFA2T3-GLIS2-dependent pediatric acute megakaryoblastic leukemia is driven by GLIS2 and sensitive to navitoclax. Cell Rep. 2023 Sep 26;42(9):113084.

Petrogiannis-Haliotis T, Pehr K, Roberge D, Rys RN, Monczak Y, Popradi G, Ajjamada L, Benlimame N, Querfeld C, Johnson N, Knecht H. Primary Cutaneous Multifocal Indolent CD8+ T-Cell Lymphoma: A Novel Primary Cutaneous CD8+ T-Cell Lymphoma. Biomedicines. 2023 Feb 20;11(2):634.

EXCITING RESEARCH IN THE PIPELINE

Project Titles: 1) Understanding the role of eIF4A in AML progression and relapse 2) Small activating RNAs targeting transcription factors as a therapeutic approach for AML

Investigator: Dr. Francois Mercier (CO-PI)

Funding: CIHR - $929,475 and CIHR - $726,751

Dates: 2022-2027 and 2022-2028

Dr. Mercier’s research aims to understand mechanisms underlying AML relapse and new therapeutic avenues, using a wide variety of novel technologies such as CRISPR genome editing in vivo, single-cell RNA sequencing technologies, nucleic acid therapeutics, and analysis of patient-donated samples. With CIHR funding, he performs translational research that aims to study the role of novel nucleic acid therapeutics and pharmacological inhibitors that regulate transcription and translation as potential therapeutic targets in AML.

Dr. Hans Knecht McGill / JGH

Dr. Chantal Seguin MUHC

Dr. Sarit Assouline JGH

Dr. Adrian Langleben SMH

Project Title: Plasma ctDNA to optimize the timing of CART therapy in relapsed DLBCL

Investigator: Dr. Nathalie Johnson (PI)

Funding: Canadian Cancer Society Challenge grant$525,000

Date: 2024-2028

Dr. Johnson collaborates with Dr. Davison (RVH) and Dr. Skamene (SMH) in this investigator-initiated multi-centre clinical trial. The aim of the study is to determine the feasibility of performing plasma ctDNA sequencing in patients with DLBCL treated with potentially curative frontline therapy. Identifying early treatment failure, before overt clinical relapse, could lead to changes in management and potentially more effective second line CAR-T therapy.

Project title: Genomic Applications Partnership Program (GAPP) Canadian Epitope Matching Program

Investigator: Dr. Chee Loong Saw (PI)

Funding: CIHR-Genome Canada - co-PI - $5.5 million

Date: 2024-2029

Dr. Saw is the director of the HLA Laboratory at the RVH since 2022. As co-PI, Dr Saw joined the Genome Canada Transplant Consortium in the application to a LSARP (Large-Scale Applied Research Project) competition hosted by CIHR-Genome Canada. They won a 5 Million CAD research project that ran from 2018 through 2024, with CAD 100,000 allocated to his lab. Their work has been successfully bridged by yet another successful grant application to GAPP (Genomics Applications Partnership Program).

IMPACTFUL CLINICAL INNOVATION

Development of a Myeloproliferative neoplasma (MPN) clinic at the MUHC

Dr. Jonathan How

Since the development of the MPN clinic at the MUHC, Dr. How is participating in the Quebec-wide MPN Registry and MPN-related clinical trials. As a Member of the Canadian MPN Group, he participates regularly in national tumor boards and has been invited as a speaker at 3 different meetings in 2023. He supervised two research projects in 2023, involving PGY2 internal medicine residents, investigating the outcomes of myelofibrosis patients undergoing alloSCT and outcomes of older adult patients undergoing alloSCT. Submitted abstracts on this research were presented at high-profile hematology meetings. He has been a co-author on an oral abstract presentation on The Combination of Navitoclax and Ruxolitinib in JAK Inhibitor-Naïve Patients with Myelofibrosis Mediates Responses Suggestive of Disease Modifications. This work was presented in Rome, Italy in October 2023. He also co-authored work published in Lancet (Verstovsek et al; Momelotinib versus danazol in symptomatic patients with anaemia and myelofibrosis (MOMENTUM): results from an international, double-blind, randomised, controlled, phase 3 study. Lancet. 2023 Jan 28;401(10373):269-280) In 2023, Dr. How was also the recipient of the Douglas Kinnear Award, for his exceptional interest and skill of teaching clinical medicine.

Dr. Marcel Behr McGill / MUHC

INFECTIOUS DISEASES

Dr. Karl Weiss JGH

Dr. Joe Dylewski SMH

16 Clinician-Teachers

11 Scientists

8 Clinician-Scientists

5 Clinician-Investigators

3 Clinician-Administrators

1 Clinician-Educator

5 NOTABLE 2023 PUBLICATIONS

(Division or DOM primary member’s name in bold type)

Guidelines for Diagnosis and Management of Infective Endocarditis in Adults: A WikiGuidelines Group Consensus Statemen. McDonald EG, Aggrey G, Tarik Aslan A, Casias M, Cortes-Penfield N, Dong MQD, Egbert S, Footer B, Isler B, King M, Maximos M, Wuerz TC, Azim AA, Alza-Arcila J, Bai AD, Blyth M, Boyles T, Caceres J, Clark D, Davar K, Denholm JT, Forrest G, Ghanem B, Hagel S, Hanretty A, Hamilton F, Jent P, Kang M, Kludjian G, Lahey T, Lapin J, Lee R, Li T, Mehta D, Moore J, Mowrer C, Ouellet G, Reece R, Ryder JH, Sanctuaire A, Sanders JM, Stoner BJ, So JM, Tessier JF, Tirupathi R, Tong SYC, Wald-Dickler N, Yassin A, Yen C, Spellberg B, Lee TC.. JAMA Netw Open. 2023 Jul 3;6(7):e2326366.

Salmonella Typhimurium expressing chromosomally integrated Schistosoma mansoni Cathepsin B protects against schistosomiasis in mice. Hassan AS, Houle S, Labrie L, Perera DJ, Dozois CM, Ward BJ, Ndao M. NPJ Vaccines. 2023 Feb 27;8(1):27.

Clinical Characteristics and Outcomes Among Travelers With Severe Dengue : A GeoSentinel Analysis. Huits R, Angelo KM, Amatya B, Barkati, S, Barnett ED, Bottieau E, Emetulu H, Epelboin L, Eperon G, Medebb L, Gobbi F, Grobusch MP, Itani O, Jordan S, Kelly P, Leder K, Diaz-Menendez M, Okumura N, Rizwan A, Rothe C, Saio M, Waggoner J, Yoshimura Y, LIbman M, Hamer DH, Schwartz E. Ann Intern Med 2023 Jul;176(7):940-948. doi: 10.7326/M23-0721

Coronavirus Disease 2019 and Airborne Transmission: Science Rejected, Lives Lost. Can Society Do Better? Lidia Morawska,  William Bahnfleth, Philomena M Bluyssen, Atze Boerstra, Giorgio Buonanno, Stephanie J Dancer, Andres Floto, Francesco Franchimon, Charles Haworth, Jaap Hogeling, Christina Isaxon, Jose L Jimenez, Jarek Kurnitski, Yuguo Li, Marcel Loomans,  Guy Marks, Linsey C Marr, Livio Mazzarella, Arsen Krikor Melikov, Shelly Miller, Donald K Milton, William Nazaroff, Peter V Nielsen, Catherine Noakes, Jordan Peccia, Xavier Querol,  Chandra Sekhar, Olli Seppänen,  Shin-ichi Tanabe, Raymond Tellier, Tham Kwok Wai,  Pawel Wargocki, Aneta Wierzbicka. Clinical Infectious Diseases, Volume 76, Issue 10, 15 May 2023, Pages 1854–1859

Liquid-liquid phase separation of nucleocapsid proteins during SARS-CoV-2 and HIV-1 replication. Bao-An Chau,  Venessa Chen, Alan W. Cochrane, Leslie J. Parent,  Andrew J. Mouland Cell Reports, Volume 42, Issue 1, 31 January 2023, 111968

EXCITING RESEARCH IN THE PIPELINE

Project title: The S. aureus Network Adaptive Platform (SNAP) trial

Leads: Drs. Matthew Cheng, Emily McDonald and Todd Campbell Lee

The S. aureus Network Adaptive Platform (SNAP) trial – led in Canada by Drs Cheng, McDonald and Lee – has now recruited more than 2500 patients worldwide (>3 times the prior largest trial) including more than 674 in Canada, and received funding from CIHR in excess of $3M, thus far.

Project title: Differential virulence within the Mycobacterium tuberculosis complex

Investigator: Dr. Marcel Behr (PI)

Funding: CIHR - Project Grant - $1,147,500

Date: 2023-2028

The Mycobacterium tuberculosis complex includes M. tuberculosis, the cause of human TB, along with M. bovis and M. orygis, the causes of TB in cattle. This grant builds upon the observation that the tubercle bacilli of cattle are more virulent across different experimental infection models, to identify the mechanisms of differential virulence.

IMPACTFUL CLINICAL INNOVATION

Nunavik Syphilis Rapid Testing

In isolated Arctic communities, long delays between testing and treatment of infectious cases contribute to an incidence >15-fold higher than the national average. In a recent multisite prospective field diagnostic accuracy study in an intended-use setting in Nunavik and Nunavut, Drs Yansouni and Libman demonstrated the diagnostic accuracy of a rapid diagnostics test (RDT) for presumed infectious syphilis using whole blood  specimens at the point-of-care (POC) by workers without laboratory training. Then, leveraging data from STAR study and bio-behavioural data from the 2017 Nunavik Health Survey, this team developed a data-driven individual-based model of syphilis transmission suggesting that 21-46% of new syphilis infections could be averted over the next 10 years if the RDT were deployed across the region. Based on this body of work, a gradual scale-up of RDT (with Nunavik health structures and Public Health authorities) was initiated with the intention of use for routine sexually transmitted infection screening in all 14 Nunavik villages.

MEDICAL BIOCHEMISTRY

6 Clinician-Teachers

2 Clinician-Scientists

2 Scientists

1 Clinician-Administrator

1 Clinician-Investigator

5 NOTABLE 2023 PUBLICATIONS

(Division or DOM primary member’s name in bold type)

Zhang R, Li J, Badescu D, Karaplis AC, Ragoussis J, Kremer R. PTHrP Regulates Fatty Acid Metabolism via Novel lncRNA in Breast Cancer Initiation and Progression Models. Cancers (Basel). 2023 Jul 25;15(15):3763. doi: 10.3390/cancers15153763. PMID: 37568579; PMCID: PMC10417726

Mihalcioiu C, Li J, Badescu D, Camirand A, Kremer N, Bertos N, Omeroglu A, Sebag M, Di Battista J, Park M, Ragoussis J, Kremer R. Improved platform for breast cancer circulating tumor cell enrichment and characterization with next-generation sequencing technology. Am J Cancer Res. 2023 Jan 15;13(1):25-44. PMID: 36777514; PMCID: PMC9906071.

Increased FH-Risk-Score and Diabetes Are Cardiovascular Risk Equivalents in Heterozygous Familial Hypercholesterolemia. Paquette M, Cariou B, Bernard S, Hegele RA, Gallo A, Genest J, Trinder M, Brunham LR, Béliard S, Baass A. Arterioscler Thromb Vasc Biol. 2024 Feb;44(2):505-512. doi: 10.1161/ATVBAHA.123.319957. Epub 2023 Nov 30.PMID: 38031840

Metabolic syndrome predicts cardiovascular risk and mortality in familial hypercholesterolemia. Paquette M, Bernard S, Cariou B, Hegele RA, Genest J, Trinder M, Brunham LR, Béliard S, Baass A. J Clin Lipidol. 2023 May-Jun;17(3):376-383. doi: 10.1016/j.jacl.2023.03.008. Epub 2023 Mar 22.PMID: 37003850

Kavsak PA, Clark L, Arnoldo S, Lou A, Shea JL, Eintracht S, Lyon AW, Bhayana V, Thorlacius L, Raizman JE, Tsui Y, Djiana R, Chen M, Huang Y, Booth RA, McCudden C, Lavoie J, Beriault DR, Blank DW, Fung AWS, Hoffman B,Taher J, St-Cyr J, Yip PM, Belley-Cote EP, Abramson BL, Borgundvaag B, Friedman SM, Mak S, McLaren J, Steinhart B, Udell JA, Wijeysundera HC, Atkinson P, Campbell SG, Chandra K, Cox JL, Mulvagh S, Quraishi AU, Chen-Tournoux A, Clark G, Segal E, Suskin N, Johri AM, Sivilotti MLA, Garuba H, Thiruganasambandamoorthy V, Robinson S, Scheuermeyer F, Humphries KH, Than M, Pickering JW, Worster A, Mills NL, Devereaux PJ, Jaffe AS. Analytic Result Variation for High-Sensitivity Cardiac Troponin: Interpretation and Consequences. Can J Cardiol. 2023 Apr 23:S0828-282X(23)00361-6.doi: 10.1016/j.cjca.2023.04.013. Epub ahead of print. PMID: 37094710.

Dr. David Blank MUHC

Dr. Elizabeth MacNamara JGH

EXCITING RESEARCH IN THE PIPELINE

Project Title: Anti-parathyroid hormone-related protein (PTHrP) monoclonal antibodies against metastatic cancer

Investigator: Dr. Richard Kremer (PA)

Funding: Canadian Institutes of Health Research (CIHR) Project Grant

Date: 2023-2026

Project Title: Co-targeting parathyroid-hormone related protein (PTHrP) signaling and osteoclast activation to counter breast cancer metastasis to bone

Investigator: Dr. Richard Kremer (PA)

Funding: Canadian Institutes of Health Research (CIHR) Project Grant

Date: 2023-2028

Project Title: Identification des facteurs de risque de pancréatite aigue chez les sujets souffrant de chylomiconémie multifactorielle

Investigator: Dr. Alexis Baass

Funding: Réseau CMDO Grant - $40 000

Determining the genetic and epigenetic factors associated with acute pancreatitis in patients with severe hypertriglyceridemia.

IMPACTFUL CLINICAL INNOVATION

New platform using a microfluidic technology to capture circulating tumor cells

Drs. Richard Kremer and Catalin Mihalcioiu

Dr. Richard Kremer with his colleague Dr. Catalin Mihalcioiu established a revolutionary new platform using a microfluidic technology to capture circulating tumor cells (CTCs) from the blood circulation of melanoma patients as to examine cancer progression in real time.

MEDICAL ONCOLOGY

9 Scientists

4 Clinician-Teachers

5 NOTABLE 2023 PUBLICATIONS

(Division or DOM primary member’s name in bold type)

Atezolizumab plus bevacizumab versus active surveillance in patients with resected or ablated high-risk hepatocellular carcinoma (IMbrave050): a randomised, open-label, multicentre, phase 3 trial. Qin S, Chen M, Cheng AL...Asselah J..., Wu C, Chow PKH; IMbrave050 investigators. Lancet. 2023 Nov 18;402(10415):1835-1847.

Pembrolizumab plus chemotherapy versus placebo plus chemotherapy for HER2-negative advanced gastric cancer (KEYNOTE-859): a multicentre, randomised, double-blind, phase 3 trial. Rha SY, Oh DY, Yañez P, Bai Y...Asselah J..., Bhagia P, Wyrwicz LS; KEYNOTE-859 investigators. Lancet Oncol. 2023 Nov;24(11):1181-1195.

Improved platform for breast cancer circulating tumor cell enrichment and characterization with next-generation sequencing technology. Mihalcioiu C, Li J, Badescu D, Camirand A, Kremer N, Bertos N, Omeroglu A, Sebag M, Di Battista J, Park M, Ragoussis J, Kremer R.Am J Cancer Res. 2023 Jan 15;13(1):25-44. eCollection 2023.

Phase II LEAP-004 Study of Lenvatinib Plus Pembrolizumab for Melanoma With Confirmed Progression on a Programmed Cell Death Protein-1 or Programmed Death Ligand 1 Inhibitor Given as Monotherapy or in Combination. Arance A, de la Cruz-Merino L, Petrella TM, Jamal R, Ny L, Carneiro A, Berrocal A, Márquez-Rodas I, Spreafico A, Atkinson V, Costa Svedman F, Mant A, Khattak MA,  Mihalcioiu C, Jang S, Cowey CL, Smith AD, Hawk N, Chen K, Diede SJ, Krepler C, Long GV.J Clin Oncol. 2023 Jan 1;41(1):75-85.

Intrathecal trastuzumab versus alternate routes of delivery for HER2-targeted therapies in patients with HER2+ breast cancer leptomeningeal metastases. Lazaratos AM, Maritan SM, Quaiattini A, Darlix A, Ratosa I, Ferraro E, Griguolo G, Guarneri V, Pellerino A, Hofer S, Jacot W, Stemmler HJ, van den Broek MPH, Dobnikar N, Panet F, Lahijanian Z, Morikawa A, Seidman AD, Soffietti R, Panasci L, Petrecca K, Rose AAN, Bouganim N, Dankner M.Breast. 2023 Jun;69:451-468.

EXCITING RESEARCH IN THE PIPELINE

Project Title: Platform for the enrichment of circulating tumor cells (CTCs) for characterization and sensitivity to anti-cancer drugs

Investigators: Drs. Catalin Mihalcioiu & Richard Kremer

Funding: CQDM - $299,392

This liquid biopsy platform using an innovative circulating tumour cell detection method, will be available at the CIM as a platform available for research.

Dr. Nathaniel Bouganim MUHC

Dr. Gerry Batist JGH

Dr. Adrian Langleben SMH

Project Title: The creation of a Quebec consortium for Sarcoma research (SarcQ)

McGill Sarcoma program will now lead and consolidate all adult clinical trials from McGill University Health Center and Hospital Maisonneuve Rosemont. These trials are now conducted via the CIM Oncology platform. The consolidation of these two hospital clinical trial programs into a single centre has increased patient enrollment and advanced sarcoma research, making the McGill Sarcoma program competitive internationally.

Project Title: McGill University Health Center phase 1 research program

After one full year of operation, it has grown exponentially, testing first-in-human therapies. It has already shown its ability to compete and outperform other Quebec phase 1 units and has started working with researchers to bring therapies from bench to bedside.

Project Title: CIM Oncology

CIM Oncology continues to have huge success internationally. Some accomplishments include having the highest worldwide recruitment for trials MEK ARRY 134 and SGN PDL1V. Trial startup, pre-activation, activation and recruitment process timelines have been optimized and have made CIM Oncology capable of recruiting first internationally in many trials such as EVOPAR and Actinium. Our contributions and recruitments to Checkmate-816 and Keynote-671 have yielded two NEJM publications.

Project Title: Cellular therapies in solid cancers such as CART

Cellular therapies in solid cancers such as CART will be starting in the upcoming year. This will place McGill as a leader in CART for Solid tumors in Quebec.

IMPACTFUL CLINICAL INNOVATION

Clinical trial management software MEDCT

Increasing success in the oncology clinical trial program has led to the search and deployment of a clinical trial management software to the phase 1 unit. This system, “MEDCT,” has been capable of providing 20/20 vision in trial standing, patient recruitment, as well as giving real-time key performance indexes. We hope to extend the deployment of MEDCT to phase 2-3 studies and possibly to non-Oncology research

NEPHROLOGY

19 Clinician-Teachers

6 Clinician-Scientists

2 Clinician-Investigators

1 Scientist

5 NOTABLE 2023 PUBLICATIONS

(Division or DOM primary member’s name in bold type)

Al-Aubodah TA, Aoudjit L, Pascale G, Perinpanayagam MA, Langlais D, Bitzan M, Samuel SM, Piccirillo CA, Takano T. The extrafollicular B cell response is a hallmark of childhood idiopathic nephrotic syndrome. Nat. Commun. 2023 Nov 24;14(1):7682

Vinson AJ, Zhang X, Dahhou M, Süsal C, Döhler B, Melk A, Sapir-Pichhadze R, Cardinal H, Wong G, Francis A, Pilmore H, Foster BJ. A multinational cohort study uncovered sex differences in excess mortality after kidney transplant. Kidney Int. 2023 Jun;103(6):1131-1143.

Sannier G, Nicolas A, Dubé M, Marchitto L, Nayrac M, Tastet O, Chatterjee D, Tauzin A, Lima-Barbosa R, Laporte M, Cloutier R, Sreng Flores AM, Boutin M, Gong SY, Benlarbi M, Ding S, Bourassa C, Gendron-Lepage G, Medjahed H, Goyette G, Brassard N, Delgado GG, Niessl J, Gokool L, Morrisseau C, Arlotto P, Rios N, Tremblay C, Martel-Laferrière V, Prat A, Bélair J, Beaubien-Souligny W, Goupil R, Nadeau-Fredette AC, Lamarche C, Finzi A, Suri RS, Kaufmann DE. A third SARS-CoV-2 mRNA vaccine dose in people receiving hemodialysis overcomes B cell defects but elicits a skewed CD4+ T cell profile. Cell Rep. Med. 2023 Mar 21;4(3):100955.

Solomon J, Festa MC, Chatzizisis YS, Samanta R, Suri RS, Mavrakanas T. Sodium-glucose co-transporter 2 inhibitors in patients with chronic kidney disease. Pharmacol. Ther. 2023; Feb; 242: 108330.

Sandal S, Ahn JB, Chen Y, Massie AB, Clark-Cutaia MN, Wenbo W, Cantarovich M, Segev DL, McAdams-DeMarco MA. Trends in the survival benefit of re-kidney transplantation over the past three decades. Am. J. Transplant. 2023 Jan 23(5): 666-672.

EXCITING RESEARCH IN THE PIPELINE

Project Title: Pathogenesis of idiopathic nephrotic syndrome: defining the role of B cells and autoantibodies reactive to podocyte proteins

Investigators: Drs. Tomoko Takano (PI) & Ciriaco Piccirillo (CO-PI)

Funding: Canadian Institutes of Health Research (CIHR) - $956 250

Date: 2023-2028

Idiopathic nephrotic syndrome (INS) is an important cause of nephrotic syndrome in children and adults. While patients with INS may respond to general immunusuppresion, renal biopsies from patients with INS lack specific features usually associated with inflammatory glomerular disorders, and the pathogenesis of INS remains uncertain. Importantly, to date, the lack of an appropriate animal model of INS has precluded detailed understanding of its pathogenesis. Our lab has successfully developed a novel mouse model of INS. Using cultured cells and kidney organoids, we will test if INS is mediated by antibodies

Dr. Rita Suri McGill / MUHC

Dr. Mark Lipman JGH

Dr. Johana Eid SMH

which specifically target podocytes. Using single cell RNA sequencing, we will identify the immune cells responsible for producing these antibodies. Our results have the potential to be transformative, including establishing INS as an autoimmune disease, identifying the renal cellular targets, and the origin of the autoantibodies. In the long-term, these results will help identify biomarkers to allow more accurate diagnosis, and the development of personalized, novel, and safer therapies for INS.

Project Title: Identification, description, and prognostic significance of latent classes based on hemodynamic indicators for patients on maintenance

hemodialysis

Investigators: Drs. Thomas Mavrakanas (PI), Baroz F (CO-I), Suri R (CO-I), Takano T (CO-I), Sharma A (CO-I), Brophy M (CO-I) & Dendukuri N (CO-I)

Funding: Canadian Institutes of Health Research (CIHR) - $191 250

Date: 2023-2025

There are currently ~45,000 Canadians receiving kidney replacement therapy. End-stage kidney disease drastically reduces patients’ quality of life and conveys significant risks for cardiac events, hospitalizations and death. Blood pressure variations during the hemodialysis procedure are associated with poor outcomes but remains poorly characterized despite its prevalence. Machine learning is a branch of artificial intelligence aiming at issuing predictions based on statistical relationships within a training dataset, without being explicitly programmed to do so. Latent class analysis is an unsupervised machine learning approach with recent applications in medical research, as it allows to identify “hidden” groups (latent classes) from “observed” data, by maximizing within-groups similarities and between-groups differences. We will use latent class analysis to identify phenotypes of patients with different blood pressure responses during dialysis. We will determine if these phenotypes are associated with clinical outcomes, including mortality, myocardial infarction, stroke, heart failure, and hospitalizations. We expect results from this study to help identify pathological blood pressure variations during dialysis. This knowledge will in turn help designing future interventional trials to improve clinical outcomes for patients receiving hemodialysis.

Project Title: A health systems approach to improve the care of kidney transplant recipients with graft failure

Investigator: Dr. Shaifali Sandal (PI)

Funding: Canadian Institutes of Health Research (CIHR) - $328 951

Date: 2023-2027

Kidney transplantation can significantly improve the lives of patients with kidney disease. However the life span of a transplanted kidney is limited, and many patients experience graft failure. Patients with graft failure experience a life-altering event for which they are often poorly prepared and poorly supported. Many are not re-transplant candidates and some die after experiencing graft failure. It is known that patients with graft failure experience fragmented transitions of care between the transplant and dialysis teams. Patient perspectives are poorly researched and poorly understood, thus poorly translated into clinical practice. Using qualitative methods, we will obtain the perspectives of patients who are in different stages of graft failure as well as their caregivers, living kidney donors and health care professionals. We then aim to develop healthcare approaches to improve care delivery that are consistent and aligned with the self-identified needs and expectations of patients with graft failure and their caregivers. This work model will help us to implement care models that allow earlier integration of physical symptoms, and psychological and functional support to kidney transplant recipients whilst guiding clinical practice and supporting the education of current and future health care teams.

IMPACTFUL CLINICAL INNOVATION

Excellence in Polycystic Kidney Disease Care: The Quebec PKD Network

Dr. Ahsan Alam

Autosomal Dominant Polycystic Kidney Disease (PKD) is the most common inherited kidney disease. Most people who are affected will require dialysis or a kidney transplant in their lifetime, as to date, there is no cure.

The McGill University Health Center PKD Clinic was established in 2015 and represents the first of its kind and one of the largest in Quebec. This clinic provides specialized care for patients with PKD with access to multidisciplinary care, cutting-edge treatments and opportunities to participate in research studies. Strong links between nephrology and other specialties at the MUHC, including medical genetics, diagnostic and interventional radiology, urology, hepatology, pediatric nephrology, medical obstetrics, and neurosurgery provides patients seamless connection to interdisciplinary care. Trainees of varied backgrounds can take advantage of this rich training environment, from nurse practitioner and medical students, to residents in internal medicine, medical genetics, adult and pediatric nephrology, as well as plasticizing clinicians seeking preceptorships.

Recognized as a leader in PKD care in Quebec, Dr. Alam built on the success of the MUHC PKD clinic to establish the Quebec PKD Network. The Quebec PKD Network is a community of physicians and other stakeholders in Quebec committed to enhancing the care, outcomes, and experience of PKD patients. Founded by Dr. Alam in 2023 in partnership with Dr. Guillaume Bolle (Centre hospitalier de l’Université de Montréal), Dr. Daniel Bichet (Hôpital du Sacré-Coeur), Dr. Normand Proulx (Hôpital de Hull), Dr. Daniel Garceau (Hôpital Laval IUCPQ) and Luisa Miniaci-Di Leo, a patient partner, the objective of the network is to ensure that all patients with PKD in Quebec receive the highest quality care possible. The Quebec PKD Network also aims to provide a collective voice for patients with ADPKD (advocacy and support), increase patient and provider knowledge and expertise in all areas of ADPKD care (medical education), and support capacity and resources to conduct high quality ADPKD research in Quebec.

PHYSIATRY / REHAB SERVICE

3 Clinician-Teachers

1 Clinician-Scientist

5 NOTABLE

2023 PUBLICATIONS

(Division or DOM primary member’s name in bold type)

Aita R, Klaylat T, Petruccelli JA, St-Jean G, Radhakrishna M, Gawri R, Gao C. A novel mouse model of polytrauma with spinal cord injury – induced heterotopic ossification. European Cells & Materials, 2023(47), 73-90.

Mazerolle M, Kimoff RJ, Khadadah S, Duquette P, Jobin V, Lapierre Y, Benedetti A, Majetic K, Robinson A, Roger E, Bar-Or A, Kaminska M, Leonard G, Trojan DA. Long term effects of continuous positive airway pressure treatment of obstructive sleep apnea-hypopnea syndrome in multiple sclerosis patients. Multiple Sclerosis and Related Disorders 2023 (doi.org/10.1016/jmsard.2023.105144).

Mazerolle M, Kimoff RJ, Khadadah S, Duquette P, Jobin V, Lapierre Y, Benedetti A, Majetic K, Robinson A, Roger E, Bar-Or A, Kaminska M, Leonard G, Trojan DA. Longterm treatment with continuous positive airway pressure of obstructive sleep apnea-hypopnea in multiple sclerosis patients is associated with improved fatigue and quality of life. Multiple Sclerosis Journal 2023;29 :3 Suppl: 4-136. (Abstract # 0088-504, doi:10.1177/13524585221196191). This abstract was presented as a platform presentation at the annual ECTRIMS meeting in Milan, Italy.

EXCITING RESEARCH IN THE PIPELINE

Project Title: NMD4C: the neuromuscular network for Canada

Investigator: Dr. Daria Trojan (CO-A)

Funding: Canadian Institutes of Health Research & Muscular Dystrophy Canada - $2,000,000

Date: 2023-2028

Lochmuller H with Canadian Neuromuscular Network investigators including Trojan DA (co-applicant). Operating grant, “NMD4C: the neuromuscular network for Canada.” Funded by the Canadian Institutes of Health Research and Muscular Dystrophy Canada for $400,000 per year for 5 years ($200,000 per year from each of the two agencies). The funds provide support for work in neuromuscular disease across three pillars: preclinical science, clinical research, and clinical practice.

Project Title: Ectopic bone formation and pain associated with spinal cord injury

Investigator: Dr. Chan Gao (PI)

Funding: McGill Regenerative Medicine Network$9,840

Date: 2023-2023

Dr. Mohan Radhakrishna MUHC

Project Title: Ossification Hétérotopique et Douleur associées aux Lésions de la Moelle Epinière

Investigator: Dr. Chan Gao (PI)

Funding: Fonds de recherche du Québec - Santé (FRQS)

- Starting Grant for Young Clinician-Investigators$60,000

Date: 2023-2027

Project Title: Ossification Hétérotopique et Douleur associées aux Lésions de la Moelle Epinière

Investigator: Dr. Chan Gao (PI)

Funding: Fonds de recherche du Québec - Santé (FRQS)Clinical Research Scholar, Junior 1 – Salary Award

Date: 2023-2027

IMPACTFUL CLINICAL INNOVATION

Victims of domestic violence can end up in shelters with sequelae of traumatic brain injuries

Dr. Jennifer Massad

Were you aware that victims of domestic violence can end up in shelters with sequelae of traumatic brain injuries?

Dr. Jennifer Massad as part of the Traumatic Brain Injury team is creating a pathway to evaluate and treat victims of domestic violence for traumatic brain injuries (concussions).

RESPIRATORY MEDICINE

25 Clinician-Teachers

16 Clinician-Scientists

12 Scientists

4 Clinician-Investigators

3 Clinician-Educators

2 Clinician-Administrators

5 NOTABLE 2023 PUBLICATIONS

(Division or DOM primary member’s name in bold type)

Association of dysanapsis with mortality among older adults Vameghestahbanati M, Sack C, Wysoczanski A, Hoffman EA, Angelini E, Allen NB, Bertoni AG, Guo J, Jacobs DR Jr, Kaufman JD, Laine A, Lin CL, Malinsky D, Michos ED, Oelsner EC, Shea SJ, Watson KE, Benedetti A, Barr RG, Smith BM. Eur Respir J. 2023 Jun 8;61(6):2300551. doi: 10.1183/13993003.005512023. PMID: 37263750.

Chronic low-level JUUL aerosol exposure causes pulmonary immunologic, transcriptomic, and proteomic changes. Been T, Alakhtar B, Traboulsi H, Tsering T, Bartolomucci A, Heimbach N, Paoli S, Burnier J, Mann KK, Eidelman DH, Baglole CJ. FASEB J. 2023 Feb;37(2):e22732. doi: 10.1096/fj.202201392R. PMID: 36694994.

Neonatal imprinting of alveolar macrophages via neutrophil-derived 12-HETE. Pernet E, Sun S, Sarden N, Gona S, Nguyen A, Khan N, Mawhinney M, Tran KA, Chronopoulos J, Amberkar D, Sadeghi M, Grant A, Wali S, Prevel R, Ding J, Martin JG, Thanabalasuriar A, Yipp BG, Barreiro LB, Divangahi M. Nature. 2023 Jan 4. doi: 10.1038/s41586-022-05660-7. PMID: 36599368

Winters N, Belknap R, Benedetti A, Borisov A, Campbell JR, Chaisson RE, Chan PC, Martinson N, Nahid P, Scott NA, Sizemore E, Sterling TR, Villarino ME, Wang JY, Menzies D. Completion, safety, and efficacy of tuberculosis preventive treatment regimens containing rifampicin or rifapentine: an individual patient data network meta-analysis. Lancet Respir Med. 2023 Mar 23:S2213-2600(23)00096-6. doi: 10.1016/S22132600(23)00096-6. Online ahead of print. PMID: 36966788.

Assayag D, Adegunsoye A, Sheehy R, Morisset J, Khalil N, Johannson KA, Marcoux V, Kolb M, Fisher JH, Manganas H, Wrobel J, Wilsher M, De Boer S, Mackintosh J, Chambers DC, Glaspole I, Keir GJ, Lee CT, Jablonski R, Vij R, Strek ME, Corte TJ, Ryerson CJ. Sex- And Race-Based Differences In The Treatment Of Interstitial Lung Diseases in North America And Australasia. Chest. 2023 Jan 5:S00123692(23)00018-1. doi: 10.1016/j.chest.2022.12.039. Online ahead of print. PMID: 36621759.

Dr. Basil Petrof McGill

Dr. Ronald Olivenstein MUHC

Dr. Jason Agulnik JGH

Dr. Harold Zackon SMH

EXCITING RESEARCH IN THE PIPELINE

Project Title: Canada Excellence Research Chair in Lung Regenerative Medicine

Investigator: Dr. Darcy Wagner

Funding: CERC in Lung Regenerative Medicine$8 million

This research will combine stem cell biology with new manufacturing techniques including 3D bioprinting to create lung tissue with high precision. The ultimate goal is to generate functional respiratory tissue with the potential for clinical translation.

Project Title: Decoding how the aryl hydrocarbon receptor (AhR) controls cigarette smoke-induced lung inflammation and development of chronic obstructive pulmonary disease (COPD)

Investigators: Drs. Carolyn Baglole (PI), Gregory Fonseca (CO-PI) & Jun Ding (CO-PI)

Funding: Canadian Institutes of Health Research (CIHR) - Project Grant - $940,950

This grant is focused on understanding how the AhR protects against acute inflammation and the development of COPD. They will examine a non-classical AhR pathway in macrophages to understand how it mitigates the pathological consequences of cigarette smoke exposure in the lungs, and whether therapeutically targeting this pathway could prevent lung damage caused by cigarette smote.

Project Title: Improving Canadian Lung Cancer Screening Efficiency with a Computed Tomography Risk Classifier

Investigators: Drs. Benjamin Smith (PI), Andrea Benedetti (CO-PI) & Nicole Ezer (CO-PI)

Funding: Canadian Institutes of Health Research (CIHR) - Project Grant - $914,175

Ranked 1st in the Public, Community & Population Health Committee. Variation in airway tree calibre is common in the general population and this variation is strongly associated with higher risk of lung cancer death among smokers. This study will examine whether a baseline CT airway tree risk classifier can improve lung cancer screening efficiency in Canada.

Project Title: Understanding Barriers and Facilitators to the Treatment of Sleep-Disordered Breathing in Pregnancy and Postpartum

Investigators: Drs. Sushmita Pamidi (PI) & John Kimoff (CO-PI)

Funding: Canadian Institutes of Health Research (CIHR)Project Grant - $179,776

Sleep-disordered breathing occurs in ~ 30% of pregnant individuals and is associated with pregnancy and postpartum complications, yet patients show poor adherence to treatment options. This study will assess barriers and facilitators to treatment use and help design personalized and patient-led treatment interventions.

IMPACTFUL CLINICAL INNOVATION

The CANadian Consortium of Clinical Trial TRAINing (CANTRAIN)

Dr. Jean Bourbeau

The CANadian Consortium of Clinical Trial TRAINing (CANTRAIN) project, initiated by Dr. Jean Bourbeau, will receive more than $11 million over three years from the CIHR Clinical Trials Fund. This project will adopt an equitable, diversified and inclusive approach to training the professionals who conduct clinical trials in Quebec and across Canada.

RHEUMATOLOGY

7 Clinician-Teachers

5 Clinician-Scientists

3 Clinician-Educators

3 Clinician-Investigators

2 Scientists

1 Clinician-Administrator

5 NOTABLE 2023 PUBLICATIONS

(Division or DOM primary member’s name in bold type)

Lee JE*, Mendel A, Askanase A, Bae SC, Buyon JP, Clarke AE, Costedoat-Chalumeau N, Fortin PR, Gladman DD, Ramsey-Goldman R, Hanly JG, Inanç M, Isenberg DA, Mak A, Mosca M, Petri M, Rahman A, SanchezGuerrero J, Urowitz M, Wallace DJ, Bernatsky S, Vinet É. Systemic Lupus Erythematosus Women with Lupus Nephritis in Pregnancy Therapeutic Challenge (SWITCH): The Systemic Lupus International Collaborating Clinics experience. Ann Rheum Dis. 2023 Nov;82(11):1496-1497. doi: 10.1136/ard-2023- 224197. Epub 2023 May 19. PMID: 37208152.

Zhao, Naizhuo, Audrey Smargiassi, Hong Chen, Jessica Widdifield, and Sasha Bernatsky. “Systemic autoimmune rheumatic diseases and multiple industrial air pollutant emissions: a large general population Canadian cohort analysis.” Environment International 174 (2023): 107920.

Colmegna, Inés, and Michael Libman. “The 2022 ACR vaccination guideline: a call-to-action.” Nature Reviews Rheumatology 19.5 (2023): 263-264.

Yu JCY, Zeng Y, Zhao K, Lu T, Oros Klein K, Colmegna I, Lora M, Bhatnagar SR, Leask A, Greenwood CMT,  Hudson M. Novel insights into systemic sclerosis using a sensitive computational method to analyze wholegenome bisulfite sequencing data. Clin Epigenetics. 2023 Jun 3;15(1):96.

Leclair V, Tsui H, Hudson M. Pain in autoimmune inflammatory myopathies: a scoping review. RMD Open. 2023 Jan;9(1):e002591.

EXCITING RESEARCH IN THE PIPELINE

Project Title: Safety and immUnogenicity of Covid-19 vaCcines in systEmic immunE mediated inflammatory Diseases (SUCCEED)

Funding: Public Health Agency of Canada (PHAC)/ COVID Immunity Task Force (CITF) - $3,131,216

Date: 2021-2023

Dr. Laeora Berkson McGill / JGH

Dr. Elizabeth Hazel MUHC

Dr. Jan Schulz SMH

Project Title: Safety and immUnogenicity of Covid-19 vaCcines in systEmic immunE mediated inflammatory Diseases (SUCCEED I & II)

Funding: Public Health Agency of Canada (PHAC)/ COVID Immunity Task Force (CITF) - $528,568

Date: 2023-2023

Project Title: Multicriteria decision analysis with 1000Minds for developing scleroderma renal crisis classification criteria

Investigators: Drs. Marie Hudson (PI), Denton C (CO-PI) & Johnson S (CO-PI)

Funding: Canadian Initiative for Outcomes in Rheumatology cAre (CIORA) - $60,000

Date: 2023-2024

IMPACTFUL CLINICAL INNOVATION

CAR-T cell therapy for autoimmune disease

JGH is part of an emerging national network to increase capacity in CAR-T cell therapy for autoimmune disease including myositis and scleroderma. (Hudson, Leclair, Cotton)

YARD (Young Adults with Rheumatic Diseases)

Dr. Elizabeth Hazel

The YARD (Young Adults with Rheumatic Diseases) clinic accepts patients transitioning from pediatric to adult care. The YARD clinic has incorporated career counsellors and social workers (as well as PT, OT). Successful transfer has improved from 48% to 94%.

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TAKE YOUR WORK SERIOUSLY, BUT DON’T TAKE YOURSELF SERIOUSLY.

– Clint Eastwood

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