Annual Report 2015-2016 by McMaster University Department of Surgery

ANNUAL REPORT

McMaster University | Department of Surgery | 2015-2016

Celebrating 50 Years as a world leader in the provision of evidence-based surgical education, research, and patient care.

INTRODUCING OUR ALL-NEW WEBSITE!

SURGERY.McMASTER.CA

Our Vision The McMaster University Department of Surgery strives to maintain its reputation as a world leader in the provision of evidence-based surgical education, research, and patient care.

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Table of Contents

Messages From...

Patrick Deane President and Vice-Chancellor at McMaster University

Dr. Paul O’Byrne

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Dean and Vice-President of the Faculty of Health Sciences and Dean of the Michael G. DeGroote School of Medicine

Dr. Susan Reid Academic Chair and Professor, McMaster University’s Department of Surgery

Dr. Mohit Bhandari Associate Chair of Research, McMaster University’s Department of Surgery

Dr. Stephen Kelly Associate Chair of Education, McMaster University’s Department of Surgery

Cathy Turner Director of Administration, McMaster University’s Department of Surgery

Divisional Reports

Features 15 Faculty Grant Highlights 17 Publication Highlights

19 Award Highlights 24 Research Groups 46 Surgery Education 52 Education Groups & Programs

78 Cardiac Surgery

68 Endowed Chairs

84 General Surgery

71 Canada Research Chairs

88 Neurosurgery

140 Resident Research Day

94 Pediatric Surgery

142 Alumni Message

102 Plastic Surgery

146 Faculty Roster

108 Ophthalmology

152 Publication History

112 Orthopaedics 118 Otolaryngology 122 Thoracic Surgery 126 Urology 130 Vascular Surgery

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Patrick Deane, PhD President and Vice-Chancellor McMaster University

A Message from the President & Vice Chancellor I wish to extend my sincere congratulations to all members of the Department of Surgery for your continued outstanding achievements in research, education, and patient care. The Department has played a crucial role in the success of McMasterâ&#x20AC;&#x2122;s medical school for many years and the important and groundbreaking research contributions made by your faculty have directly supported the Universityâ&#x20AC;&#x2122;s high research rankings and prominence on the world stage. Over the last few years, the Departmentâ&#x20AC;&#x2122;s faculty compliment has increased and includes a mix of senior faculty, known nationally and internationally as scholars and researchers, as well as promising and talented mid-career and junior faculty members. With the professionalism and mentorship initiatives now in place to nurture faculty, as well as the clinical scholar and fellowship programs designed to prepare young surgeons for a future of excellence, the Department is well positioned to thrive and excel for many years to come.

The vision of the Department is to be the world leader in the provision of evidence-based surgical education, research, and patient care; with the initiatives currently underway and the talent and creativity at your disposal, I have no doubt of your ability to achieve this and to expand and develop even further. I thank you all for your dedication and support and for the positive difference that you make to the lives of current and future patients every day. I expect to hear much more about your excellent work and accomplishments in 2017 and beyond.

Patrick Deane, PhD President and Vice-Chancellor McMaster University

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Paul Oâ&#x20AC;&#x2122;Byrne, MD Dean and Vice-President - Faculty of Health Sciences Dean of the Michael G. DeGroote School of Medicine

A Message from the Dean and Vice-President Congratulations to the faculty and staff of the Department of Surgery on yet another wonderful year full of success. It is your hard work and dedication that maintains McMaster’s position as a strong leader in surgery education, high-quality research, and clinical care. The Department of Surgery has grown to 100 full-time and more than 200 part-time and adjunct faculty members over 11 divisions. In reflecting on the significant achievements of this group over the past year, I have been reminded of the many reasons why this department continues to shine in our Faculty. One that stands out is the Centre for Minimal Access Surgery, which has trained thousands in delivering state-of-the-art, multi-disciplinary, technological education and research. It offers 20 courses annually to train surgeons and nurses in the latest techniques of minimal access surgery, and provides a mentorship program to assist surgeons in adopting these innovative techniques. Also on display is the Department’s unwavering commitment to evidencebased surgery, and how the Surgical Outcomes Research Centre (SOURCE) has evolved to become a world leader in this area.

As well, the Centre for Surgical Invention and Innovation (CSii), which focuses on cutting-edge research in medical robotic technologies and techniques, and the clinical validation and safe use of new technologies and processes, continues to make great strides in these areas. To that end, it was awarded a Build in Canada Innovation Program contract worth over $500,000 from the Government of Canada, in association with the Canadian Space Agency, Public Works and Government Services Canada. Showcasing the exceptional talent of faculty members, numerous awards were brought home in the past year. Notably, Dr. Achilleas Thoma took the 2016 Canadian Society of Plastic Surgeons Lifetime Achievement Award; and Dr. Dan Poenaru received the 2015 Surgical Humanitarianism Award of the American College of Surgeons for starting East Africa’s first pediatric surgical fellowship. In addition, the Department continues to conduct impactful research that sees many faculty leading or involved in large multi-centre, international studies. Findings are also routinely published in high-impact journals, and highlighted in media coverage. For example, an international team of researchers led by Dr. Mohit Bhandari

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McMaster University Medical Center

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found that the standard practice of using soap and water to clean open wounds before surgery is actually less effective than just using clean water. This was published in The New England Journal of Medicine and reported in a range of media from CTV News to The Boston Globe. CBC, CTV and The Hamilton Spectator were among the media who highlighted Dr. Christian Finley’s Canadian Partnership Against Cancer discussion paper, which led to recommendations to reduce the variability in patient outcomes between provinces and improve surgical cancer care across the country. There have certainly been many accomplishments to celebrate and I would like to thank Dr. Susan Reid for her excellent leadership of the Department in 2015-2016. I wish you all continued success in your mission to train skilled surgeons and innovative surgical researchers who will save lives and improve the health of patients at home and abroad.

“The Department continues to conduct impactful research that sees many faculty leading or involved in large multi-centre, international studies.”

Paul O’Byrne, MD Dean and Vice-President Faculty of Health Sciences Dean of the Michael G. DeGroote School of Medicine

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Susan Reid, BA, MD, FRCPS(C) Academic Chair and Professor Department of Surgery

A Message from Our Academic Chair Since our last report, the Department has seen considerable growth as Faculty recruitment continues to be a priority; we added four new surgeons in 2016, have named three new surgeons to start in July of 2017, with an additional six Divisions currently entrenched in recruitment processes. This year is an exciting time for the Department (and the Medical School), as it rings in the 50th anniversary of the Academic Department; Dr. Barber Meuller, foundational Chair of the Department of Surgery was appointed in July 1967. We will be planning a worthy celebration to include alumni, faculty, staff, and peers in the fall of 2017. In mid-2016, we created our Department Five-Year Review, which was well received by the Faculty of Health Sciences and our peers. The opportunity to create the review has allowed us to take stock and re-focus our departmental and divisional priorities For 2017 and 2018, key initiatives for the Department will include the continuation of a Financial Health Project intended to protect our academic mandate within the Department. The Financial Review Committee has expanded to include representation from each Division as we move forward to explore our options, seek further cost savings, and pursue new fundraising opportunities. As well, we have been enhancing research and educational supports through the Offices of Surgical Research Services (Director Dr. Forough Farrokhyar) and Education Science (Director, Dr. Ranil Sonnadara). We

have expanded these teams to meet a vigorous research mandate and the quickly transforming educational needs as Competency By Design takes hold in our training programs. In addition, the Department has begun enhancing our outward-facing profile through a new Communications Coordinator position, held by Maria Lee Fook. Maria has worked to build a strong social media presence and to shape a refreshed website on a new platform, among other projects. We look forward to the movement of the Department Administrative team to Lakeview Lodge on the JHCC campus in the spring of 2017. This team includes Department Administrator Cathy Turner, her Assistant Terrie Harvie, the Human Resources staff (Office Manager Anne Lancaster and Human Resources Assistant Laurie Dennison), our centralized Finance team (Finance Manager Marcy Murchie and Finance Assistants Ann Kolkin, Tanya Nesvit, and Nick Gervais), our newest Administrative Team member, Maria Lee Fook, Communications Coordinator, and, of course, my Administrative Assistant Brenda Paine. Our Education lead, Kathy Wilson, will remain in the B3 area supporting the Associate Chair of Education, Dr. S. Kelly. We are thankful to the administration of Hamilton Health Sciences for working with our Department to create this space. Strategic planning discussions continue to help form and leverage forward movement for our Divisions and Programs. In 2015, we launched External Divisional Reviews to be undertaken every five

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years for each Division. These Departmentcommissioned reviews are held twice annually in the spring and fall. To date, we have completed four reviews, which have resulted in not only accolades for superior performance, but also a number of helpful recommendations to enhance our teaching, research, and clinical care environments. Together with our hospital partners — in particular with our Chiefs of Surgery at Hamilton Health Sciences and St. Joseph’s Healthcare Hamilton — and respective Clinical Management teams, our faculty, staff, and administrators continue to provide excellent support to our Department vision as world leaders in the provision of evidenced-based patient care, education, and research. This report highlights the efforts that each of our Divisions are undertaking to fulfil our mission to teach the next generation of surgeons, and enhance the delivery of safe, innovative, and effective patient care. Personally, I have been honoured to serve as the academic Chair of the Department of Surgery. I am immensely proud of our faculty and staff and consider it a privilege to witness the caring, knowledgeable, and innovative skills that our faculty bring to our community each and every day.

“I am immensely proud of our faculty and staff and consider it a privilege to witness the caring, knowledgeable, and innovative skills that our faculty bring to our community each and every day.”

Please enjoy the report! Susan Reid, BA, MD, FRCPS(C) Academic Chair and Professor Department of Surgery

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“... providing evidence-based surgical education, research and patient care.”

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Faculty members in the Department of Surgery were awarded $11.8 million in 27 research grants as Primary Investigators in 2015-2016. Of the 27 grants received in 2015-2016, we would like to call attention to the following high impact projects:

Dr. Mohit Bhandari - Advancing the Care of Patients with Musculoskeletal Injuries Worldwide through Multi-National Research Initiatives, CIHR Foundation Grant, July 2016â&#x20AC;&#x201C;June 2023 Dr. Jehonathan Pinthus - Role of androgen deprivation therapy in cardiovascular disease - a longitudinal prostate cancer study (RADICAL PC), Prostate Cancer Canada, April 2015-March 2020 Dr. Sheila Singh - Targeting Clonal Heterogeneity in TreatmentRefractory Glioblastoma with novel and Empiric Immunotherapies, Terry Fox Research Institute, February 2016-February 2019 Dr. Sheila Singh - A Novel Model of Human Brain Metastasis from Lung Cancer: Discovering Genes that Regulate Brain Metastasis, CCSRI Inn-Imp, February 2016-February 2019 Dr. Michelle Ghert - Prophylactic Antibiotic Regimens in Tumor Surgery (PARITY), CCSRI Impact Grant, February 2015-January 2018 Dr. Yaron Shargall - Extended Low-Molecular Weight Heparin VTE Prophylaxis in the Thoracic Surgical population, a randomized controlled pilot study, CIHR Operating Grant July 2015-June 2016 Dr. Richard Whitlock - Left Atrial Appendage Occlusion Study (LAAOS III), Heart & Stroke, January 2016-December 2018

Grant Highlights

Faculty Grant Highlights

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Grant Highlights

Our annual McMaster Surgical Associates grants competition was held in January 2015 and 2016 consecutively, with 15 research projects funded in 2015 totalling $410,000 and 16 research projects funded in 2016 totalling $450,000 in the categories of education research, basic science, clinical science, and innovation. All grants had a start date of July 2015/2016.

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Publication Highlights

Rodriguez AR, Larrazabal Ramiro. Intracranial arteriovenous malformation. N Engl J Med 2015 Jan 15; 372(3):e4 (Case report) Whitlock RP, Healey JS, Holmes DR. Left atrial appendage occlusion debate revisited. Circulation. 2015 Feb 24;131(8):756-61. Badhiwala JH, Lai CK, Alhazzani W, Farrokhyar F, Nassiri F, Meade M, Mansouri A, Sne N, Aref M, Murty N, Witiw C, Singh S, Yarascavitch B, Reddy K, Almenawer SA. Cervical spine clearance in obtunded patients after blunt traumatic injury: a systematic review. Ann Intern Med. 2015 Mar 17; 162(6):429-37. Wrobel K, Stevens SR, Jones RH, Selzman CH, Lamy A, Beaver TM, Djokovic LT, Wang N, Velazquez EJ, Sopko G, Kron IL, DiMaio JM, Michler RE, Lee KL, Yii M, Leng CY, Zembala M, Rouleau JL, Daly RC, Al-Khalidi HR. Influence of Baseline Characteristics, Operative Conduct, and Postoperative Course on 30-Day Outcomes of Coronary Artery Bypass Grafting Among Patients With Left Ventricular Dysfunction: Results From the Surgical Treatment for Ischemic Heart Failure (STICH) Trial. Circulation. 2015 Aug 25;132(8):720-30. Le Manach Y, Collins G, Bhandari M, Bessissow A, Boddaert J, Khiami F, Chaudhry H, De Beer J, Riou B, Landais P, Winemaker M, Boudemaghe T, Devereaux PJ. Outcomes After Hip Fracture Surgery Compared With Elective Total Hip Replacement. JAMA. 2015 Sep 15;314(11):1159-66.

Publication Highlights

We continued our upward trend in publication numbers, with 371 publications, and 33% having resident authors. Highlighted below are those publications from 2015-2016 with impact factors greater than 10:

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Publication Highlights

Whitlock RP, Devereaux PJ, Teoh KH, Lamy A, Vincent J, Pogue J, Paparella D, Sessler DI, Karthikeyan G, Villar JC, Zuo Y, Avezum Ă , Quantz M, Tagarakis GI, Shah PJ, Abbasi SH, Zheng H, Pettit S, Chrolavicius S, Yusuf S; SIRS Investigators. Methylprednisolone in patients undergoing cardiopulmonary bypass (SIRS): a randomised, double-blind, placebocontrolled trial. Lancet. 2015 Sep 26;386(10000):1243-53. Badhiwala JH, Nassiri F, Alhazzani W, Selim MH, Farrokhyar F, Spears J, Kulkarni AV, Singh S, Alqahtani A, Rochwerg B, Alshahrani M, Murty NK, Alhazzani A, Yarascavitch B, Reddy K, Zaidat OO, Almenawer SA. Endovascular Thrombectomy for Acute Ischemic Stroke: A Meta-analysis. JAMA. 2015 Nov 3;314(17):1832-43. Whitlock RP, Healey JS, Holmes DR. Response to Letter Regarding Article, "Left Atrial Appendage Occlusion Debate Revisited." Circulation. 2015 Nov 10;132(19):e230. FLOW Investigators, Bhandari M, Jeray KJ, Petrisor BA, Devereaux PJ, Heels-Ansdell D, Schemitsch EH, Anglen J, Della Rocca GJ, Jones C, Kreder H, Liew S, McKay P, Papp S, Sancheti P, Sprague S, Stone TB, Sun X, Tanner SL, Tornetta P 3rd, Tufescu T, Walter S, Guyatt GH. A Trial of Wound Irrigation in the Initial Management of Open Fracture Wounds. N Engl J Med. 2015 Dec 31;373(27):2629-41 Chaudhry H. Total hip arthroplasty after hip fracture. BMJ. 2016 Apr 27;353:i2217. Editorial Gandhi S, Ganame J, Whitlock R, Chu V, Natarajan MK, Velianou JL Double Trouble: A Case of Valvular Disease in Pregnancy. Circulation. 2016 May 31;133(22):2206-11. TRUST Investigators Writing Group, Busse JW, Bhandari M, Einhorn TA, Schemitsch E, Heckman JD, Tornetta P 3rd, Leung KS, HeelsAnsdell D, Makosso-Kallyth S, Della Rocca GJ, Jones CB, Guyatt GH. Re-evaluation of low intensity pulsed ultrasound in treatment of tibial fractures (TRUST): randomized clinical trial. BMJ. 2016 Oct 25;355:i5351. Sukkar L, Hong D, Wong MG, Badve SV, Rogers K, Perkovic V, Walsh M, Yu X, Hillis GS, Gallagher M, Jardine M. Effects of ischaemic conditioning on major clinical outcomes in people undergoing invasive procedures: systematic review and meta-analysis. BMJ. 2016 Nov 7;355:i5599. doi: 10.1136/bmj.i5599.

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Awards

Dr. Michael Gupta was appointed head of the Clinical Faculty Association, 2015 Dr. Mohit Bhandari received the Attorney Generalâ&#x20AC;&#x2122;s Victim Services Award of Distinction; The College of Physicians and Surgeons of Ontario Council Award; and Hamilton's Gallery of Distinction Award, June 2016 Dr. Richard Whitlock received the Department of Surgery Chairs Award for Distinction in Research, 2016 Dr. Deepak Dath received the Department of Surgery Chairs Award for Distinction in Education, 2016 Dr. John Harvey received the Medical Staff Association Humanitarian Award for Community and Global Service, 2016 Dr. Carolyn Levis was honoured by the President of Ukraine, and received the Award of Merit for her work with the Canada Ukraine Foundation Dr. Achilleas Thoma recipient of the Canadian Society of Plastic Surgeons, Lifetime Achievement Award, 2016 Drs. Christian Finely and Colin Schieman received the award for Excellence in Clinical Education, 2016 Dr. WaĂŤl Hanna was appointed to the Editorial Board of The Journal of Thoracic and Cardiovascular Surgery, 2016 Dr. John Harlock was appointed Program Director in Vascular Surgery, 2016

Award Highlights

Dr. Michelle Ghert was elected as the to the Association of Bone and Joint Surgeons, March 2015

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Dr. Mohit Bhandari, MD, PhD, FRCS(C) Associate Chair of Research

A Message from Our Associate Chair of Research Strategic recruitment of surgeon-scientists and surgeons with a strong interest in clinical research has strengthened our Department brand, expanding it from fundamental research to large, definitive clinical trials. Our focus on evidence-based practice in both education and research embodies the growing culture of patient-centered care — putting patients’ values and preferences first in our research and educational initiatives. The emphasis on evidence-based surgery has paid important dividends, including a growing trend toward higher impact publications, a doubling of research funding from grants over the last three years, and a greater inclusiveness across many of our Divisions in clinical research. The past year has demonstrated high-impact contributions in cardiovascular surgery, orthopaedic surgery, and neurosurgery, to name but a few Department success stories. Research from these Divisions has garnered prestigious publications in The New England Journal of Medicine, The Lancet, JAMA, Annals of Internal Medicine, and BMJ. Large clinical programs such as the FLOW multinational trial in fractures (N. Engl J. Med) or the SIRS trial (Lancet) represent the scale and opportunity at McMaster that is unparalleled across Canada. In keeping with McMaster’s “Forward with Integrity” document and the Faculty of Health Science’s tenets of inter-professional collaboration, strategic partnerships, and innovation, the Department of Surgery has a mission of advancing research in

all aspects of surgical care, from bench to bedside utilizing the most modern technical advances and the principles of evidence-based surgery. Translational research has been an important area of focus this past year. Research into quality improvement and standardization is improving care both in our Local Health Integrated Network (LHIN) as well as nationwide. Further, we are embracing education research as a dedicated discipline with a target of leading major advances in the field. Our Department’s legacy, however, will be less about our individual successes in publishing or conducting high-quality trials, but more so on our ability to identify, inspire, and develop talent. The Surgeon Scientist, Surgical Research Methodology Program, and the ongoing mentoring within our toptier research programs have fuelled an ever-increasing focus on research, providing our residents with the tools necessary to be highly successful. It is with great pride that we will look back at our Department’s research contributions as those that mentored and created the next generation of surgeons committed to research as the vehicle to inform better decisionmaking for our patients.

Dr. Mohit Bhandari, MD, PhD, FRCS (C) Associate Chair of Research

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Dr. Forough Farrokhyar, Bsc, MPhil, PhD. Director, Office of Surgical Research Services & Surgical Research Methodology

Members of the Office Of Research Services (left to right: Sabrina Chaudhry, Katey Savage, Gabriella Johnson, Leigh Mahan)

Office of Surgical Research Services (OSRS) Under the direction of Dr. Forough Farrokhyar, the OSRS has provided the Department substantial support over the last five years with respect to their contribution to research projects, research funding, and publications. Offering services in methodology, question definition, analytics, manuscript and grant writing, budgeting and monitoring support, since 2010, the OSRS has helped to generate over $2.5 million toward surgical research and contributed to more than 140 department publications. Dr. Farrokhyar continues to work on reaching out to new faculty surgeons to provide research support and reaching out to those surgeons with research interests but who have little time and/or resources. In addition, Dr. Farrokhyar works to sustain funds from successful grants with allocated funding for OSRS methodological and statistical services. All services are available to Department Residents and Faculty. Additionally, the OSRS is providing educational workshops on research methodology to research personnel, interested faculty, residents, and fellows within the Department. OSRS hosts quarterly development seminars for research staff within the Department, aiming to build the necessary skills to coordinate and submit a successful research grant, conduct a meta-analysis, monitor projects, etc. These events have been presented by senior research assistant staff within the Department, further providing development to existing staff.

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Research Groups

MacOrtho MacOrtho is a world leader in clinical research in the field of orthopaedic surgery. Dr. Mohit Bhandari has lead MacOrtho research to the forefront of a paradigm shift in how orthopaedic research is being conducted worldwide. With collaborators located across numerous countries, MacOrtho is building relationships and expanding our network to conduct global orthopaedic research, transcending orthopaedic care across borders. MacOrtho is moving from orthopaedic surgery trials that were generally single-centre initiatives with too few patients to yield definitive answers on clinically important questions to a global scale reaching trial milestones for patient enrollment. Dr. Bhandari fosters an environment for the Clinician Scientists within MacOrtho to flourish and succeed, making it a continued leading academic institution for research in the field of orthopaedic surgery.

Centre of EvidenceBased Orthopaedics (CEO) The Centre for Evidence-Based Orthopaedics (CEO) has been gaining recognition as a leading research centre for evidence-based orthopaedics since its establishment back in 2012. Its objective is to improve patient care by producing high-quality clinical research that will answer clinically relevant questions, and by identifying and disseminating novel therapies through high-quality, collaborative research initiatives. The CEO continues to be led by the Founding Executive Director, Dr. Mohit Bhandari. CEO is organized into research units led by a Unit Head who provides oversight for the research activities within the units of: Trauma and Injury (Drs. Brad Petrisor and Bill Ristevski), Degenerative Joint Disease (Dr. Justin de Beer), Musculoskeletal Tumor Surgery (Drs. Michelle Ghert and Ben Deheshi), Sports Medicine (Dr. Olufemi Ayeni), and Disorders of the Spine (Dr. Brian Drew). Each research unit represents a unique focus within orthopaedic surgical research and, generally, the debilitating injuries which affect people of all ages and are operationalized primarily by the conduct of multinational definitive randomized controlled trials (RCT) and large observational cohort studies.

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Research Groups

Orthopaedic Surgery Research Initiatives FIRST Using a two-arm blinded RCT design, we will compare arthroscopic lavage versus osetochondroplasty for Femoroacetabular impingement on patient pain, function, and quality of life up to one year across sites in Canada, Denmark, America, and Finland.

FAITH FAITH was a large multi-centre randomized controlled trial comparing sliding hip screw and cancellous screw fixation in femoral neck fracture patients. The primary manuscript will be published in The Lancet and we are currently conducting a series of secondary analyses based on the trial data.

FAITH 2 The Faith 2 trial seeks to identify a surgical and nutritional strategy to minimize fracture fixation complications and to optimize bone health in order to improve patient outcomes in non-geriatric patients with hop fractures (femoral neck fractures). Faith 2 will use a 2x2 factorial randomized design â&#x20AC;&#x201D; we will compare two surgical implants (sliding hip screws versus cancellous screws) and nutritional supplementation (vitamin D3, 4,000 international units per day for six months versus placebo) on patient important complications and quality of life in 807 non-geriatric-aged (18-60) femoral neck fracture patients.

INORMUS A large multi-centre, international, prospective cohort study that will include 40,000 patients with muscoskeletal trauma (fractures and/ or dislocations) from Africa, Asia, and Latin America. The objective of the INORMUS study is to determine the incidence of major complications (mortality, re-operation, and infection) and the factors associated with these major complications.

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PARITY PARITY is a large multi-centre randomized controlled trial comparing long-term (five days) with short-term (24 hours) postoperative antibiotic regimens in patients undergoing surgical excision and endoprosthetic reconstruction of a lower extremity bone tumour. The primary outcome is rate of infection.

EDUCATE The aim of this prospective mixed-methods study is to implement and evaluate a multifaceted, evidence-based IPV educational program designed to empower HCPs to assist women experiencing IPV within the fracture clinic setting. Both qualitative and quantitative methodologies will be used to evaluate the educational program over a 12-month post-training period.

HEALTH HEALTH is a large, multi-centre, randomized controlled trial comparing total hip arthroplasty with hemi-arhroplasty in patients with femoral neck fractures. The primary outcome is revision surgery rates at 24 months post initial hip surgery.

PRAISE-2 PRAISE-2 is a pilot prospective cohort study of 300 women of fractures that aims to determine the feasibility of a large multinational cohort study that will examine surgical outcomes (time to fracture healing, fracturerelated adverse events, and return to pre-injury function) among those injured women who report, or do not report, a history of abuse. This will be the first study to evaluate differences in orthopaedic outcomes between abused and non-abused women and preliminarily assess whether an injury can lead to worsening abuse by an intimate partner.

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Research Groups

Orthopaedic Surgery Research Initiatives SPOC-CBT The primary objective of this multi-centre RCT is to determine if cognitive behavioural therapy (CBT) reduces persistent postsurgical pain (PPSP) in patients with extremity fractures treated with internal fixation who report unhelpful illness beliefs after surgery. The pilot phase of this trial is currently in start-up at several sites across North America.

FLOW The Flow Trial, which investigated the effect of different irrigation solutions (soap versus saline) and irrigation pressure (high-pressure versus low-pressure versus gravity flow) on patient important outcomes is now completed and the results have been published in The New England Journal of Medicine. The FLOW investigators are currently writing a number of secondary papers based on the data from this international trial of over 2,500 patients.

DRIVSAFE Distractions on the Road: Injury Evaluation in Surgery and Fracture Clinics (DrivSafe) is a cross-sectional study, which is currently enrolling patients at the HHSC General Site, that aims to assess the burden of distracted driving on patients who present to orthopaedic fracture clinics.

VITA-SHOCK The primary aim of this phase-II exploratory trial is to assess the effect of vitamin D3 supplementation on fracture healing in healthy adult patients with femoral or tibial shaft fractures. This trial will also inform the feasibility of the large phase-III RCT.

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Research Groups

Surgical Outcomes Research Centre (SOURCE) The Surgical Outcomes Research Centre (SOURCE) is a global leader in EvidenceBased Surgery (EBS). Under the leadership of Directior Dr. Achilleas Thoma, SOURCE continues to develop its “Users’ Guides to the Surgical Literature” article series that is being published in The Canadian Journal of Surgery (CJS). Each article is prefaced with a surgical scenario, and the series is intended to educate surgeons, surgical fellows, and residents on how to find, appraise, and incorporate evidence from the surgical literature into surgical practice. Currently, 17 articles from this series have been published in CJS. The SOURCE committee currently has the following articles in progress: • Gallo L, Eskicioglu C, Braga L, Farrokhyar F, Thoma A. Users’ guide to the surgical literature: how to assess an article using surrogate outcomes. • Thoma A, Farrokhyar F, Sprague S, Braga L. Users’ guide to the surgical literature: how to assess an article using about noninferiority trials. • Cadeddu M, Thoma A, Eskicioglu C, Braga L. Ergonomic Issues in Surgery. • Braga L, Thoma A, Eskicioglu C, Cadeddu M, Ghert M, Farrokhyar F. Users’ guide to the surgical literature: how to assess an article about pilot studies.

• Kaur M, Moll S, Thoma A. Users’ guide to the surgical literature: how to assess an article about qualitative studies. EBS Workshops for McMaster Surgery Faculty: Hamilton, ON, Canada SOURCE has also developed an interactive EBS Workshop based on the article series. The workshop consists of small group tutorials led by trained surgeon tutors addressing various topics covered in the EBS article series. Our past tutors have included: Dr. Achilles Thoma, Dr. Luis Braga, Dr. Michelle Ghert, and Dr. Forough Farrokhyar. Our recent workshops in February of 2016 and 2017 focused on Systematic Reviews and Meta-Analyses (2016) and Harm in Surgery (2017). Publication Highlights: Thoma A, Kaur MN, Farrokhyar F, Waltho D, Levis C, Lovrics P, Goldsmith CH. (2016). Users’ guide to the surgical literature: how to assess an article about harm in surgery. Can J Surg 59(5):351-7 Waltho D, Kaur MN, Haynes RB, Farrokhyar F, Thoma A. (2015). Users’ guide to the surgical literature: how to perform a high-quality literature search. Can J Surg; 58(5): 349-58

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Research Groups

The MPSRC was formed in October 2008 by a group of pediatric surgeons dedicated to advancing surgical care for children through research activities that are evidencebased, rigorous, accountable, and translatable. The MPSRC conducts a wide variety of clinical research that incorporates several research paradigms, including mixed methods, quantitative, and qualitative methodologies. In order for the MPSRC to succeed in achieving excellence in clinical research, we work with a wide variety of health care professionals and participants, including patients and their families, pediatricians, child life workers, nursing staff, research methodologists, biostatisticians, family physicians, and the community.

Highlights 2015 CAPS Annual Meeting The MPSRC enjoyed great success at the 2015 Canadian Association of Pediatric Surgeons (CAPS) Annual Meeting that took place in September of 2015. Two presentations were given by members of the MPSRC. As well, congratulations are in order for Dr. Mike Livingston, who won Best Podium Presentation for “Are some children with empyema at risk for treatment failure with fibrinolytics? A multicenter cohort study.” Podium: Livingston MH, Cohen E, Pirrello D, Mahant S, Weinstein M, Connolly B, Himidan S, Giglia L, Butter A, Walton MJ. Are some children with empyema at risk for treatment failure with fibrinolytics? A multicenter cohort study. Canadian Association of Pediatric Surgeons. Niagara Falls, Ontario, September 17-19, 2015. Poster: Livingston MH, Shawyer AC, Rosenbaum PL, Jones SA, Walton MJ. Fundoplication versus percutaneous gastrojejunostomy for gastroesophageal reflux in children with neurologic impairment: a survey of pediatric surgeons in Canada. Canadian Association of Pediatric Surgeons. Niagara Falls, Ontario, September 17-19, 2015.

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2015 McMaster International ROP Conference The 2015 McMaster International ROP Conference was held on September 25-26 in Toronto, Ontario in anticipation of the development of national ROP guidelines. This conference attracted international experts on ROP from four different continents, and our very own Dr. Kourosh Sabri served as Conference Chair.

2016 TAC Annual Meeting Recently, two members of the MPSRC attended the 2016 Trauma Association of Canada (TAC) Annual Meeting on May 6-7, 2016. Congratulations to Adriana Dekirmendjian for her oral presentation on “A retrospective examination of current clinical treatment of pediatric blunt spleen and liver injuries at a single tertiary care centre.” Oral Presentation: Dekirmendjian A, Bailey K, Blinder H, Easterbrook B. A Retrospective Examination of Current Clinical Treatment of Paediatric Blunt Spleen and Liver Injuries at a Single Tertiary Care Center. Trauma Association of Canada (TAC) 2016 Annual Scientific Meeting and Conference. Halifax, Nova Scotia, May 7, 2016.

CMAS Skills Training Lab

Research Groups

Centre for Minimal Access Surgery (CMAS) CMAS is a state of the art multidisciplinary technological and research centre designed to support research and development and to advance the scope of training of specialized techniques of minimal access surgery, robotic surgery, and surgical innovations. CMAS runs approximately 25 courses per year to train surgeons, fellows, residents, and allied health professionals in the latest techniques and technology in minimal access surgery and provides mentorships to support surgeons in adapting new techniques. Devoted to skills training and educational development, the Centre supports the development of telehealth through mission critical telehealth applications. CMAS - New Courses - 2016 ATOM (Advanced Trauma Operative Management) – 12 participants Femoral Impingement Course – 11 participants from Winnipeg, London, Toronto, Hamilton AWR & Parastomal Hernia Course – New for residents and will now be running a surgeon course in 2017. EFFORT: Effective Operating Room Teaching – A new course penned to take place in 2017 and 2018. In addition, CMAS held three customized general surgery training courses for participants from United Kingdom, British Columbia, and Nova Scotia.

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Research Groups

Centre for Minimal Access Surgery (CMAS) Study Name Title

Status PI/Co/RC CMAS

Comments

POEM

Ongoing PI: Dr. Hong

Initial recruitment was completed. Additional recruitment is ongoing.

Colectomy Database

A pilot study of per oral endoscopic myotomy (POEM) in achalasia

Colectomy database

PI: Dr. Caddedu

Chart review database collecting outcomes of all colorectal surgeries

This study was otherwise run by Susan Haley. Recruitment is currently suspended. Renewal requested by Dr. Anvari. CMAS reunion consensus was that DB is incomplete and not useful. Renewed December, 2016.

GERD Study A prospective randomized study comparing laparoscopic sleeve gastrectomy and laparoscopic Rouxen-Y gastric bypass and their effect on gastroesophageal reflux disease using 24 pH monitoring.

Sleep Study

Effects of bariatric surgery on sleep apnea

PI: Dr. Anvari

Study was suspended due to low recruitment and high patient dropout.

Ongoing PI: Dr. Anvari SF: Dr. Katiraee

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This study aims to compare LSG to RYGB pre- and postsurgery GERD results.

Study is to be redesigned as a questionnaire only, to be done pre- and postoperatively for all bariatric patients. Recruitment is still open, study will be presented with current numbers at SAGES 2017 and paper is being completed.

Study Name Title Delays to Adjuvant Qt

Status PI/Co/RC CMAS

Colorectal Cancer: Ongoing PI: Dr. Getting to adjuvant Cadeddu therapy — incidence and etiology of the delay to SF: Dr. adjuvant therapy Katiraee

Utility of preop Left Lobe Measurement (LLHM) with Ultrasonography prior to LRYGB Omega-3 Comparative trial of Study prior omega-3 polyunsaturated to LRYGB fatty acids vs very low calorie liquid diet prior to bariatric surgery to determine omega-3 PUFAs will reduce left lobe liver size in an equivalent amount when compared to a VLCLD SADI vs. DS Laparoscopic Singleas a primary Anastomosis Duodenal– Bariatric ileal Bypass with procedure, Sleeve Gastrectomy five-year vs. Laparoscopic patient Duodenal Switch follow-up Effects of In obese patients RYGB on Gut undergoing RYGB, Microbiota does an increase in the and Metabolic relative abundance of Parameters gammopoteobateria in in Obese Pts stool samples over 12 with T2DM – weeks after surgery predict PILOT study metabolic changes?

Comments Chart analysis is complete at Juravinski, remaining data to be extracted from Oscar records at St. Joes by Ashna Patel.

Resident: Dr. Ashna Patel Final PI: Dr. approval Gmora granted SF: Dr. Taheri

Pending a PI: Dr. Hong signature for final SF: Dr. approval Katiraee

Ongoing PI: Dr. Hong

Recruitment ongoing.

SF: Dr. Katiraee

Ongoing PI: Dr. Hong

Recruitment complete.

SF: Dr. Pending collection of samples Katiraee, Dr. for result analysis. Bordeaux

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Research Groups

MacHand The McMaster University, Hand, Arm, Nerve (MacHANd) group is dedicated to promoting excellence in education, research, and clinical care for hand and upper extremity disorders and conditions. The MacHANd group is co-directed by Drs. Carolyn Levis (Plastic Surgery) and Joy MacDermid (Rehabilitation Sciences) and is comprised of a multi-disciplinary team of plastic surgeons, orthopaedic surgeons, physicians, rehabilitation therapists, and researchers. In 2015, machand.ca, the new MacHANd website, was launched. The 2015-2016 MacHANd Grand Rounds presented on timely and innovative topics: 1) Distal Biceps Tendon Rupture: Diagnosis and Management 2) Recovery Following Nerve Repair: Surgery and Rehab Considerations 3) Keys to Understanding and Managing Nonadherence in Musculoskeletal Rehabilitation: Barriers, Assessment Tools and Interventions 4) Hand Transplantation: Quantity vs. Quality of Life 5) Journey to Ukraine 6) The Chronic Pain Network SPOR The popular Annual MacHANd Day of Evaluation and Management of Disorders of the Upper Extremity was held at the

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Royal Botanical Gardens in Burlington, drawing a sold-out crowd of physicians, therapists, and other allied health professionals. Multidisciplinary sessions and interactive workshops disseminated the current best practice on the management of hand and upper extremity conditions. MacHANd Day also offered poster sessions that disseminated the latest hand and upper limb research. Findings from the MacHANd research projects were published in 2016: 1) Packham TL, Ball PD, MacDermid JC, Bain JR, DalCin A. A scoping review of applications and outcomes of traction orthoses and constructs for the management of intra-articular fractures and fracture dislocations in the hand. Journal of Hand Therapy. 2016 Jul-Sep;29(3):246-68. 2) Uddin Z, MacDermid JC, Moro J, Galea V, Gross AR. Psychophysical and patient factors as determinants of pain, function and health status in shoulder disorders. The Open Orthopaedics Journal, 2016, 10, 466480. 3) Nazari G, MacDermid JC, Bain J, Levis CM, Thoma A. Estimation of health-relatedquality of life depends on which utility measure is selected for patients with carpal tunnel syndrome. Journal of Hand Therapy, 2016 Dec 14. [Epub ahead of print].

Research Groups

MacTRAUMA The MacTRAUMA Research Collaborative provides a multidisciplinary forum for faculty and learners interested in trauma research to pursue their research activities. The group is comprised of members from the Hamilton Health Sciences’ Trauma Program and McMaster University’s Department of Surgery, with representation from the divisions of General, Orthopedic, Plastic, and Pediatric Surgery. MacTRAUMA provides research mentorship for undergraduate and graduate students, trauma fellows and residents, and promotes research partnerships with other clinical areas involved in trauma care. The Trauma Program maintains the Hamilton Health Sciences’ Trauma Registry, a database that collects information on all adult and pediatric trauma patients. MacTRAUMA oversees the use of the registry for health services research and quality improvement projects. Since our last report, MacTRAUMA has been successful in having research accepted for presentation at multiple peer-reviewed conferences, including the Trauma Association of Canada Annual Scientific Meeting and the National Association of EMS Physicians Annual Meeting. MacTRAUMA has also participated as a study site in a number of multi-centre studies:

almost 300 patients at eight lead trauma hospitals across Canada. • The American Association for the Surgery of Trauma Multi-Institutional Trials study entitled “Multi-center prospective, observational study on immune dysfunction in subjects who present with traumatic brain injury and receive beta adrenergic receptor blockers”, that was conducted in 15 trauma centres across North America and enrolled almost 2,000 patients. MacTRAUMA is also reaching out to involve local and regional stakeholders in collaborative quality improvement research focused on our Regional Trauma Network. T-SPIKE, or “Trauma System Performance Improvement and Knowledge Exchange,” is a project seeking to link multiple datasets within the regional trauma network to provide a more complete record of the care that our shared patients receive. It includes collaboration with Emergency Medical Services, CritiCall, Ornge, the Hamilton General Hospital, as well as our regional hospital partners in Burlington, Brantford, Cambridge, Kitchener, St. Catharines, and Guelph.

• The Multi-Centre Study on Traumatic Pancreatic Injury in Canada, a study evaluating the contemporary diagnosis and management of pancreatic trauma in

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Research Groups

Centre for Surgical Invention and Innovation (CSii) The Centre for Surgical Invention and Innovation (CSii) is a National Centre of Excellence (NCE) research accelerator dedicated to leveraging Canadian space technology for use in Image-Guided Automated Robotic (IGAR) surgical devices. This year, CSii proudly launched the first phase of its first commercial enterprise, Insight Medbotics Corporation Canada in partnership with MDA, a global leader in the aerospace industry. Under the direction of Dr. Mehran Anvari, CSii has worked with the Canadian Space Agency (CSA) and MDA to develop telerobotic capabilities for IGAR technology, which will provide patients living in remote communities with greater access to healthcare through advanced technology. The Centre is also working on plans to develop autonomous robotic surgical devices for use in future space travel and the Mars mission. The Centre is working with IBM and the Watson Collective to incorporate Watson diagnostics into IGAR technology.

CSii IGAR Breast Clinical Trials

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IGAR-Breast - MRI Suite

IGAR Control Cart

IGAR Breast â&#x20AC;&#x201C; Patient Support

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Research Groups

Insight Medbotics Corporation (IMC) Insight Medbotics Corporation (IMC) was created by CSii in partnership with MDA, builders of the iconic Canadarm, Canadarm2, and Dextre, to commercially launch a new generation of intelligent robotic systems which leverage Canadian expertise in space technology and informantics for use in Image Guided Automated Robotics (IGAR). IGAR-Breast, the first such device was designed to detect and treat breast cancer in it’s earliest stages. The goal of IMC is to establish its manufacturing base and sales and marketing operations in Southern Ontario. The venture is expected to create over 100 high tech jobs in the next five years and to attract associated industries to Canada. Insight Medbotics Leadership Paul Coopers, Vice President of MacDonald, Dettwiler and Associates (MDA), one of Canada’s largest technology companies, is responsible for mergers, acquisitions, and new business creation. MDA has partnered with CSii in the creation of IMC and the continued development of IGAR technology. A former entrepreneur and university professor, he has a Ph.D. in computer science. Peter Robertson, is the Vice-President, Commercialization for the new CSii-MDA spinoff Insight Medbotics Corporation

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Canada (IMC) and is dedicated to the growth and success of the new company and of the commercial success of IGAR, which will enable IMC to establish its manufacturing, sales, and marketing operations in Southern Ontario. Peter Robertson was appointed Vice President and General Manager of GE Healthcare Canada in 2006 and served in that capacity until 2014, successfully driving business development opportunities around the 2010 Vancouver Olympics, Digital Pathology, Public Private Partnerships, and Virtual Care Management. Peter was also active externally, serving as the Chair of MEDEC, Canada’s Trade Association for Biotech, Vice Chair of the Centre for Probe Development and Commercialization, and as a member of the Corporate Advisory Committee of the College of Health Service Executives and as a member the Ontario Health Innovation Council by appointment of the Minister of Innovation. In 2014, Peter assumed responsibility for the New York region and repositioned that organization to achieve share accretion and financial growth. Peter retired from GE Healthcare in June of 2016.

The Canadarm2 robot arm orbiting high above Aurora Australis â&#x20AC;&#x201D; aka the Southern Lights (Photo courtesy of NASA/JSC) STATUS REPORT

Research Groups

The Bariatric Registry The Bariatric Registry project consists of two components: a centralized referral system and the registry database for collection and analysis of outcomes. The Bariatric Referral System was developed by CSii at the request of the MOHLTC to provide a more single stream-lined portal for patients accessing bariatric care in Ontario. Launched in 2010, the referral system, which is fax and internet-based, was developed in partnership with the Ontario Bariatric Network (OBN) and Population Health Research Institute (PHRI) to process bariatric surgical referrals from physicians and nurse practitioners across Ontario. Dr. Mehran Anvari, Scientific Director and CEO of CSii has been appointed as an ICES adjunct scientist and the Centre is has made plans to pursue a partnership with ICES for a number of CSii clinical validation projects which include the Bariatric Registry. CSii has created a partnership and linkage of data between the Bariatric Registry and the data holdings at the Institute for Clinical Evaluative Sciences (ICES) to mutually benefit from a shared and combined accumulation of information on bariatric patients in Ontario. Expanded data sets will enhance the depth and breadth of information available on the clinical utilization of services by morbidly obese patients in Ontario, allowing for research and analysis into topics such as health

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economics and the cost of obesity-related comorbidities and socioeconomic factors effecting treatment and outcomes. Such analysis will provide a more complete picture of the health impact of obesity, and the outcomes of treatment currently provided to further develop and explore best practices for bariatric care in Ontario. The linkage of information between the Bariatric Registry and the data sets at ICES will provide a foundation for a more comprehensive assessment of obesity, bariatric treatment, healthcare resource utilization and cost, from which numerous possible research pursuits can arise. This appointment will create a closer collaboration between McMaster University and ICES, involving CSii and the Registry in this partnership, essentially creating an ICES hub at McMaster. The registry includes both surgical and medical patients and is currently in its fifth year with over 11,000 patients included in the database and over 31,000 patients referred through the bariatric referral system. The registry is supported by funding from the Ministry of Health and Long Term Care, and the registry data will ultimately lead to the development of specific Ontario guidelines and recommendations for optimal bariatric clinical care, while ensuring consistent cost-effective delivery of quality of care to all residents of Ontario.

The Ontario Bariatric Network (OBN) is a collaborative network consisting of 12 Bariatric Centres across Ontario with interdisciplinary teams of bariatric experts that provide comprehensive medical and surgical bariatric services. The 12 Bariatric Centres across Ontario include seven Bariatric Centres of Excellence (BCoEs), two Regional Assessment and Treatment Centres (RATCs), and three Surgical Only Sites. The Registry was designed to track the clinical course and outcome of each patient referred to and treated by the Bariatric Centres of Excellence across Ontario. This comprehensive database collects information on patient demographics, clinical outcomes, and socioeconomic data and is used by the Ministry to ensure safe and effective delivery of Bariatric Surgical services, but also to plan for the expansion and redistribution of these services.

The Patient Database is an observational, multi-centre, database registry designed to collect standardized information on patients undergoing bariatric treatment across Ontario. Deidentified data is collected by chart review and patientcompleted questionnaires on patient characteristics, medical status, surgical procedures, non-surgical treatments, outcomes, and economic factors which will ultimately lead to the development of specific Canadian guidelines and recommendations for optimal bariatric clinical care. The database assists in the identification of health service practices that require optimization and improvement to develop strategies to address them. The information will be used to enhance current practices and guidelines to improve bariatric patient care and outcomes in Ontario.

CSii continues to manage this Referral System across 12 Bariatric Centres across Ontario with discussion and interest to expand to other provinces. CSii has collaborated with the OBN and PHRI regarding enhancements to the Referral Portal/System and the development of an online web-based referral portal, which includes both surgical and medical bariatric program referrals.

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2016 Innovation Nation Conference & Robotics Competition The 2016 Innovation Nation Conference & Robotics Competition held Sunday, May 29th at LIUNA Station in Hamilton was an outstanding success. Each year, the Innovation Nation Conference brings together a collection of innovative thinkers from many different disciplines to present a series of talks about the nature of their work and the soul of their endeavors. This year’s keynote speakers were from diverse fields, including the aerospace industry, neuro-imaging, artificial intelligence and machine learning, engineering, and informantics.

Keynote Speakers • Sylvain Laporte, President, Canadian Space Agency   • Kirt Costello, NASA International Space Station (ISS), Deputy Chief Scientist  • Catherine (Cady) Coleman, NASA, Astronaut  • Cameron Piron, President and CoFounder, Synaptive Medical • Richard McDonald, Distinguished Engineer, International Business Machines Corporation (IBM) • Ruslan Salakhutdinov, Canada Research Chair in Statistical Machine Learning, Google Scholar, Assistant Professor, University of Toronto

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• Carolyn McGregor, Canadian Research Chair in Health Informatics University of Ontario Institute of Technology (UOIT)  • Chris Robson, Mechanical Lead, Experimental Albertan #1 • Daniel McInnis, Mechanical Engineering Student at the University of Toronto, Schulich Leaders Scholar & Young Entrepreneur  • Tony Thoma, Dean, Faculty of Engineering Technology and Media Studies at Mohawk College

CSii and The Canadian Space Agency (CSA) The Canadian Space Agency has worked with Dr. Mehran Anvari and CSii on the research and development of surgical devices and with the benefit of a Build in Canada (BCIP) CSA is currently working with CSii to ensure that a new generation of IGAR technology will increase access to healthcare by providing IGAR with telerobotic capabilities which will enable Canadians living in remote areas of the country to receive access to advanced medical care. CSii and CSA will continue to work together to develop new autonomous devices that will one day serve and protect astronauts as they explore new worlds and utilize space technology to revolutionize healthcare here on earth.

Innovation Nation 2017 Taking place on October 22, 2017 at LIUNA Station in Hamilton, ON, the 2017 conference is open to members of industry, commerce, academia, scientists, researchers, students, and to members of the public interested in attending.

Dr. Mehran Anvari presenting the cheque for first place to the team from McMaster University

Winners of the 2016 Innovation Nation Robotics Competition At the conference, students are provided with the opportunity to network with innovators and leaders in science and technology and to present their innovations to a panel of judges from business, industry, and academia, and to compete with their peers for prizes and recognition. First Place Winners: Team: X-Drive School: McMaster University, Hamilton, ON Robot: Manual to Power Wheel Chair Conversion Kit Second Place Winner Team: Brain Computer Interface Evolutionary New Prosthetics School: Glendale Secondary School, Hamilton, ON  Robot: Brain Computer Interface Evolutionary New Prosthetics Third Place Winners Team: KaST Robotics School: John Polanyi Collegiate, Toronto, ON Robot: Formulator 3D Printer

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Dr. Stephen Kelly, DM, MA, MB, BChir, FRCS Associate Chair, Education

A Message from Our Associate Chair of Education It is with great pride that I write this letter of congratulations to McMaster University’s Department of Surgery on yet another banner year. From great new programs to new accolades for deserving faculty, everybody involved with the Department of Surgery should feel the same sense of pride that I do. Among the countless crowning achievements from the past year was the astounding success of two of our flagship education programs: the Surgeon Scientist Program (SSP) and the International Surgery Desk (ISD). The SSP facilitates access to high-quality graduate research training for surgical residents and serves to encourage the pursuit of careers in academic surgery. Under the leadership of its Director, Dr. Sheila Singh, and in conjunction with McMaster University’s Clinician Investigator Program, the SSP provides surgical residents with research training opportunities through McMaster’s medical education, basic science, biotechnology/ innovation, and clinical epidemiology/health research methodology programs. The ISD, on the other hand, strives to promote the development of partnerships, the inclusion of education in all projects, the encouragement of service to low- and middle-income countries, and the contribution of knowledge generation. Dr. Brian Cameron, the ISD’s Director, has led the program to collaborations with countries like Uganda, Haiti, Guyana, and a long list of others.

surgical skills via a series of technical and nontechnical simulation-based activities, workshops, and lectures. This Boot Camp is penned to take place again in the summer of 2017, and will very likely continue on annually after that. While our programs took great strides in 2015-2016, it was an equally big year for our faculty. Altogether, nine faculty members were promoted to Associate Professor — Drs. Tim Davies, Christian Finley, Shawn Forbes, Dennis Hong, Vikram Iyer, Ted Rapanos, Dale Williams, Paul Zalzal (associate clinical professor), and Ranil Sonnadara (part-time). Finally, I’d like to extend a heart-felt thankyou to all of the wonderful Department of Surgery Program Directors and Program Coordinators — you’re the unsung heroes of a pretty remarkable operation, and should take great pride in everything you do for us. As we move forward, I am confident that our great Department will continue to take steps toward maintaining its place as a world leader in the provision of evidence-based surgical education, research, and patient care. I look forward to what the future is sure to bring! Dr. Stephen Kelly, DM, MA, MB, BChir, FRCS Associate Chair of Education

Another flagship program, Surgical Foundations, introduced its all-new “Transition to Residency” Boot Camp, which was a major success. The two-week phase rapidly develops basic

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Divisional Program Coordinators (Front-back, left-right) Jen Bowen, Plastic Surgery Abbey Payne, Orthopedic Surgery Andrea Howe, Cardiac Surgery and Vascular Surgery Katie Niblock, General Surgery Julia Smerilli, Ophthalmology Maria Cantore, Undergraduate Orthopedic Surgical Clerkship Carol Dow, Otolaryngology/Head & Neck Surgery Dr. Stephen Kelly, Associate Chair of Education Kelly Hancock, Neurosurgery Jane Klie, Surgical Foundations Lauren Douglas, Urology Paulette Aubry, Thoracic Surgery and Pediatric Surgery Not pictured: Joanne Winch, Undergraduate Clerkship

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Department of Surgery

Surgery Education

11 Divisions

6 Training Sites

49,000 Hours Post Graduate Teaching (2015-2016)

321 Faculty Full-time, Part-time, and Adjunct

14 Surgical Fellowships

From the desk of the Associate Chair of Education... The office of the Associate Chair, Education (ACE) is responsible for undergraduate and postgraduate education activity within the Department of Surgery (including surgical education research and evaluation), as well as faculty development and promotion and tenure (the Department Education Coordinator/ DEC role). The Associate Chair, Education also oversees the Surgeon Scientist Program (SSP), the International Surgery Desk (ISD), and the Office of Education Science (OES), programs run under the excellent leadership of Drs Sheila Singh (SSP), Brian Cameron (ISD), and Ranil Sonnadara (OES) respectively. Please read their individual program reports to truly appreciate the breadth and depth of scientific inquiry, international outreach, and educational research in which the Department of Surgery is involved.

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Promotion and Tenure (Department Education Coordinator) For new geographic full-time faculty joining the Department of Surgery, the successful promotion from assistant to associate professor remains a key focus. The Associate Chair, Education meets with all full-time faculty when they are first appointed, again at the six-month and one-year marks, and thereafter as needed to ensure faculty are optimally positioned for success at the time of academic review. Completed by the ACE, the Departmental Teaching Evaluation Report (DTER) continues to form an integral part of each faculty promotion dossier. The DTER contains summary tables of learner evaluations on a seven-point scale (compared with the divisional median), with the score for overall effectiveness of the teacher being the first question asked, as mandated by the McMaster Senate Committee on Appointments. Evaluations of teaching by peers remains a requirement for successful promotion at all levels, and includes evaluations conducted by multiple faculty, on multiple occasions, and in multiple settings. More attention is also being focused on the pathway for promotion from associate to full professor, to ensure all the excellent teaching and research being performed by the associate professors in the Department of Surgery who have achieved CAWAR (tenure) is recognized and rewarded by University promotion. Among full-time faculty in the Department of Surgery as of June 30, 2016, there were 17 professors, 54 associate professors,

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and 26 assistant professors. Effective July 1, 2014, three faculty in the Department of Surgery were promoted to the rank of professor: Drs. Deepak Dath (professor, General Surgery), Doron Sommer (clinical professor, Otolaryngology, Head & Neck Surgery), and Forough Farrokhyar (professor, part-time, Office of Surgical Research Services/Statistics). On top of that, six faculty were promoted to associate professor: Drs. Nalin Amin (General Surgery), Jason Archibald (Otolaryngology, Head & Neck Surgery), Victoria Avram and Femi Ayeni (Orthopaedic Surgery), and Varun Chaudhary and Amadeo Rodriguez (Ophthalmology). A year later, on July 1, 2015, nine more faculty were promoted to associate professor: Drs. Tim Davies (Urology), Christian Finley (Thoracic Surgery), Shawn Forbes and Dennis Hong (General Surgery), Vikram Iyer and Ted Rapanos (Vascular Surgery), and Dale Williams (Orthopaedic Surgery). Dr. Paul Zalzal (Orthopaedic Surgery) was promoted to associate clinical professor, and Dr Ranil Sonnadara (Office of Education Science) was promoted to associate professor, part-time.

Teaching Undergraduate Pre-Clerkship and Surgical/Orthopaedic Clerkship Programs: Department of Surgery faculty continue to provide outstanding teaching for the preclerkship, and the surgical and orthopaedic clerkship programs.

In 2014-15, approximately 15,600 hours were devoted to teaching in the Medical Foundations program, and 21,400 hours to teaching in the surgical and orthopaedic clerkship programs.

provides basic (foundational) training to all PGY 1 and 2s in the Department of Surgery with the Surgical Research Methodology program being a highlight of the Wednesday morning sessions.

In 2015-16, Department of Surgery faculty provided approximately 9,500 hours of preclerkship teaching in Medical Foundations 1-5, and nearly 24,200 hours of teaching for the surgical and orthopaedic clerkship programs.

In April 2015, all Royal College accredited programs in the Department of Surgery underwent an external review by the Royal College. All programs were approved, with feedback received from reviewers on program strengths, as well as areas for improvement, if any. The majority of the programs did not require any additional follow-up (i.e. an internal or external review) until their next regularly scheduled Royal College review in six years’ time.

These two programs continue to go from strength to strength. The surgical clerkship is led by Dr. Jorge DeMaria, and includes expanded Wednesday morning large group teaching sessions, in addition to small group discussions in the afternoon facilitated by surgical staff and chief residents. These allow all surgical clerks (irrespective of the hospital where they are working) to access the same topics, fulfilling one of the fundamental tenets of clerkship medical education at a number of different teaching sites/campuses. In March 2016, Dr. Devin Peterson took over directorship of the orthopaedic clerkship program. Postgraduate Surgical Training Programs The Department of Surgery has nine PGY 1 entry-level Royal College residency training programs (Cardiac Surgery, General Surgery, Neurosurgery, Ophthalmology, Orthopaedic Surgery, Otolaryngology Head & Neck Surgery, Plastic Surgery, Urology and Vascular Surgery), two PGY 6 entry level Royal College residency training programs (Pediatric General Surgery and Thoracic Surgery), and the Trauma Fellowship program. The Surgical Foundations program

In 2015-16, Department of Surgery faculty provided over 49,000 hours of formal postgraduate surgical teaching (lectures, small group sessions, technical skills sessions, etc.), as well as countless hours of informal (“on the fly”) clinical teaching. In 2014-15, this number was approximately 29,000. A major effort was undertaken for the 2016 merit year to capture all the indirect teaching that occurs on a regular basis in the operating room, in clinics, and on the wards, and the numbers certainly reflect the many hours surgical faculty devote to these vital teaching roles. New program directors appointed between 2014-2016 included Drs. Olufemi Ajani (Neurosurgery, 2014), Ronen Avram (Plastic Surgery, 2015), Christian Finley (Thoracic Surgery, 2016), John Harlock (Vascular Surgery, 2015), John Lee (Cardiac Surgery, 2014), Edward

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Matsumoto (Urology, 2015), and Enitan Sogbesan (Ophthalmology, 2015). Dr. Paul Engels also took over leadership of the Trauma Fellowship program in early 2015. A Breast fellowship was added to the list of surgical fellowship programs in 2015, under the direction of Dr. Barbara Heller. That list includes the following additional fellowship opportunities: Minimally Invasive Surgery (Director, Dr. Mehran Anvari); Urology, Laparoscopic, and Endourology (Director, Dr. Edward Matsumoto); Urology, Transplant (Director, Dr. Anil Kapoor); Ophthalmology, Oculoplastics, Hamilton (Director, Dr. John Harvey); Ophthalmology, Oculoplastics, Credit Valley (Director, Dr. Yasser Khan); Ophthalmology, Anterior Segment, Hamilton and Niagara (Director, Dr. George Beiko); Orthopaedic Surgery â&#x20AC;&#x201C; Sports Medicine, Pediatric Orthopaedics, Orthopaedic Trauma, Arthroplasty, Tumour (Director, Dr. Dale Williams); Plastic Surgery, Microsurgery (Director, Dr. Carolyn Levis); and Trauma (Director, Dr. Paul Engels). In 2012, the Department of Surgery residency training program expanded to the Niagara Regional Campus with a General Surgery resident starting a fiveyear training program exclusively at the regional campus. This formalized a longstanding arrangement with the hospitals in the Niagara region, which has seen many surgical residents spend part of their training there and is a natural progression following the establishment of the Niagara Undergraduate MD Program. The first resident trained at the Niagara campus will graduate from the program in June 2017.

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Awards The recipient of the 2015-2016 Margaret and Charles Juravinski Surgical Fellowship award was Dr. Ari Doumouras, currently a PGY4 in General Surgery. Dr. Doumouras completed a Master of Public Health degree at the Harvard School of Public Health, and has returned to complete his residency training in General Surgery at McMaster. The Department of Surgery remains very grateful to Margaret and Charles Juravinski for their continuing generosity and support. Dr. Paul Lysecki (PGY5 General Surgery) was the recipient of the 2015 Hamilton Health Sciences Medical Staff Association Resident of the Year award. Dr. Darren de SA (PGY5 Orthopaedic Surgery) received the award in 2016.

Dr. Cagla Eskicioglu received the Surgery Clerkship Teaching Award in 2015.

Each year, the graduating Class of the Michael G DeGroote School of Medicine, McMaster University, presents an award to outstanding faculty preceptors in the surgery and orthopedic clerkship programs. The award is voted on by the students, and the recipients for 2015 and 2016 were as follows:

Class of 2015: Surgery Clerkship Teaching Award: Dr. Cagla Eskicioglu Surgery Selective Teaching Award: Dr. Jeff Robichaud Orthopaedic Surgery Teaching Award: Dr. Richard Lachowski (awarded posthumously)

Class of 2016: Surgery Clerkship Teaching Award: Dr. Niv Sne Orthopaedic Surgery Teaching Award: Dr. Victoria Avram The success of the Department of Surgery in its educational mandate relies on the ongoing support of its chair, Dr Susan Reid, and is the result of the dedication and hard work of the departmentâ&#x20AC;&#x2122;s program directors and program coordinators, the clerkship directors and assistants, the CTU directors (both undergraduate and postgraduate), the faculty and division heads, as well as the departmentâ&#x20AC;&#x2122;s administrative support team. This solid foundation of support and collaboration will continue to serve the Department of Surgery well, especially as it transitions to the new competency-based medical

Dr. Deepak Dath received the 2016 Department of Surgery Chairs Award for Distinction in Education. education (CBME) curriculum mandated by the Royal College of Physicians and Surgeons of Canada, starting with the Otolaryngology Head & Neck Surgery residency program on July 1, 2017.

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Education Groups & Programs

Dr. Dan Poenaru working as a volunteer surgeon in Kijabe, Kenya, where he has started the Bethany Kids pediatric surgical unit within the AIC Kijabe Hospital.

Education Groups & Programs

International Surgery Desk (ISD) The McMaster International Surgery Desk (ISD) was launched in June 2010 to facilitate international surgery activity within the Department of Surgery and collaborate with like-minded disciplines and colleagues within McMaster University and the Canadian surgical community. The ISD is currently focused on development of educational partnerships with Guyana and Uganda, which have included resident and faculty exchanges, research collaborations, and development of training courses. Educational activities include an annual Global Surgery lecture, an annual ISD travel scholarship for a surgical resident elective, and lectures to graduate students in the Global Health program. We also collaborate with an online journal club for residents training through the College of Surgeons of East, Central, and South Africa. Many individual faculty members are involved in global surgery service projects and international professional collaborations, as well as a leading a number of multi-institutional clinical studies including collaborators in Low- and Middle-Income Countries (LMICs). ISD global surgery research projects have been supported by the McMaster Surgical Associates, with presentations at numerous international surgical conferences over the past five years. For example, in 2015, the ISD co-authored eight publications and four posters. In 2014, we hosted the Bethune Roundtable on International Surgery in Hamilton. The ISD collaborates locally with the McMaster Global Health Office, the St. Josephâ&#x20AC;&#x2122;s International Outreach Program, and the Departments of Anesthesia and Obstetrics & Gynecology. Nationally, we are members of the Canadian Network for International Surgery, the Canadian Coalition for Global Health Research, and we are part of the international GlobalSurg collaboration.

International Surgery Desk Hightlights: 7 Poster presentations 2015 - 2016 (Conferences worldwide). 6 published peer-reviewed journal articles 2015-2016. Visiting Scholars Dr. Phyllis Kisa (June 2015) Dr. Kisa visited with us for one week. After 18 months training in Vancouver, she returned home to become the second pediatric surgeon in Uganda. Dr. Olanrewaju Oyedepo (June 2015) Dr. Oyedepo was a clinical observer with us in pediatric anesthesiology. He works in Nigeria with our previous visitor Dr. Abdur-Rahman.

Residents Who Completed Electives Overseas: Dr. Andrew Giles (Angola 2016) Dr. Ryan Fielding (Uganda 2015) Dr. Matthew MacLeod (Uganda 2015)

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The MacOrtho Team during its annual visit to Uganda.

Education Groups & Programs

International Surgery Desk Development of Sustainable Partnerships

Guyana McMaster’s Department of Surgery has collaborated in the development and delivery of a Postgraduate Diploma in Surgery program in Guyana since 2006. This activity was summarized in the lead commentary article in the February 2015 issue of The Canadian Journal of Surgery, “Surgical training in Guyana: the next generation,” coauthored by Dr. Brian Cameron with Dr. Martin and Dr. Rambaran from Guyana. Trauma Team Training courses have been delivered and evaluated, research projects have been presented by program graduates at international conferences, and clinical programs in plastic surgery, endoscopy, and trauma have been developed. The goal of the partnership is to improve surgical care in Guyana, support clinical and educational research, and make training programs more locally sustainable. A number of Guyanese surgeons have undertaken

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clinical fellowships through McMaster in both thoracic and general surgery. In June 2015, Dr. Cheetanand Mahadeo completed his Thoracic Surgery Fellowship at St. Joseph’s Hospital and has returned to Guyana where he is based at the Georgetown Public Hospital and is building his practice in general and thoracic surgery.

Uganda The longstanding partnership between McMaster, the St. Joseph’s International Outreach Program (SJIOP), and the three main medical training centres in Uganda (Makerere, Mbarara, and Gulu) has encompassed a number of collaborative efforts with surgical faculty. McMaster’s Division of Orthopaedic Surgery, led by faculty Dr. Brad Petrisor, Dr. Desmond Kwok, and Dr. Jay Moro, continue their annual April team visits to

Uganda in collaboration with UBC’s Uganda Sustainable Trauma Orthopaedic Program/ USTOP. For example, the McMaster team — including two surgical residents, OR nurses and a physiotherapist — was involved in teaching and clinical work in Kampala in 2015. They provided basic and advanced saw-bones bio skills courses, a perioperative nursing safe surgery course, and impromptu teaching during ward rounds. Dr. Susan Reid (Chair, Department of Surgery, McMaster University) visited Makerere, Mbarara and Gulu with leaders of the SJIOP in April 2015 to meet with Ugandan surgical leaders to establish partnership priorities. In September of the same year, Dr. Brian Cameron and general surgeon Dr. Margherita Cadeddu attended the Global Partners in Anesthesia Conference and taught a basic laparoscopy course for surgical residents in Kampala. McMaster continues to welcome Ugandan surgeons as observers or trainees: pediatric surgeon Dr. Phyllis Kisa visited in 2015, and Dr. Edward Kironde started six months of orthopaedic training at McMaster in April 2016 through the SJIOP. A number of McMaster surgical residents have also completed international electives in Uganda.

Plastic Surgery). Noor took part in a volunteer medical mission with Dr. Carolyn Levis (Plastic Surgery) and the Guatemala Healing Hands Foundation in November 2016. The 2015 ISD Resident Scholarship was awarded to Dr. Matt MacLeod (PGY4 Ortho) who joined the MacOrtho team for their annual teaching and clinical visit to Uganda. He helped deliver the first international MacOrtho Acute Musculoskeletal Trauma Limb Support (AMTLS) course to Ugandan surgeons. Dr. Jessica Westerholm Kwapis (FRCSC 2011) presented surgical rounds in December 2015 on her several years of mission work in Nepal. Dr. Cameron also gives an annual lecture to students in the MSc Global Health program about the Global Burden of Surgical Disease. Dr. Cameron collaborates with colleagues in Toronto, Ireland, and East Africa in an online evidence-based journal club called Surgery in Africa, for surgical residents training through the College of Surgeons of East, Central and South Africa.

Haiti The Hamilton-based St. Joseph’s International Outreach Program has an active partnership with Haiti, and surgical faculty including orthopedic and plastic surgeons have visited Haiti.

Education in International Surgery The ISD awards the International Surgery Scholarship each year to a McMaster surgical resident or fellow who is embarking on an international surgery clinical or research elective in a low-resource region. This scholarship is funded by the ISD in the amount of $2,000. The 2016 International Surgery Desk Resident Scholarship winner was Dr. Noor Alolabi (PGY4

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Education Groups & Programs

International Surgery Desk Service to those in need in low- and middle-income countries Guatemala and Ukraine: Plastic surgeon Dr. Carolyn Levis visits Guatemala regularly, often with a McMaster resident, to provide surgical services and education for children with congenital, traumatic, and burn injuries, as part of a medical mission team with the Guatemala Healing Hands Foundation. Recently, she was presented an Award of Merit from Ukrainian President Peter Poroshenko for her work with the Canada-Ukraine Foundation medical mission. Angola: Dr. Stephen Foster, a graduate of McMaster’s first MD class and a member of the Department of Surgery’s adjunct faculty, has spent his career as a surgeon and educator in Angola. He has welcomed and taught numerous McMaster and other Canadian medical students and residents completing international electives, and was awarded the Teasdale-Corti Humanitarian Award by the Royal College of Physicians and Surgeons of Canada in 2010.

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Bolivia: Opthalmologists Dr. Gloria Isaza and Dr. John Harvey provide medical and surgical eye care services to the poor in Bolivia through Medical Ministry International. Armenia: Plastic surgeon Dr. Nasimul Huq’s efforts with Operation Rainbow focused on the provision of surgical services to Armenian patients as well as teaching local residents. Saudi Arabia: Dr. Achilleas Thoma (Plastic Surgery) and the SOURCE group at McMaster coordinate annual Evidence-Based Surgery Workshops in Saudi Arabia. China: Dr. Anil Kapoor (Urology) represented the CUA Norman Bethune Urological Society in a November teaching visit to Changsha and Wuhan cities in China and spoke at a urology symposium about advanced robotic renal surgery. Libya: Dr. Samir Faidi (General Surgery/ Trauma) has provided Advanced Trauma Course sessions in Libya.

Knowledge: Research & Dissemination Surgical faculty continue to be involved in numerous ongoing research endeavours and trials that involve large, multi-centre international collaborations. Examples include: Cardiac surgery: • Steroids in Cardiac Surgery (SIRS) trial (Dr. R. Whitlock) • Left Atrial Appendage Occlusion Study III (Dr. R. Whitlock) • CABG Off or On Pump Revascularization Study (CORONARY; Dr. A. Lamy). Orthopedic Surgery: • Fluid Lavage of Open Wounds (FLOW; Dr. Mohit Bhandari) • Fixation Using Alternative Implant for the Treatment of Hip Fractures (FAITH; Dr. Mohit Bhandari) • Hip Fracture Evaluation with Alternatives of Total Hip Arthroplasty versus Hemi-Arthroplasty (HEALTH; Dr. Bhandari); • Indian Orthopaedic Multicenter Study in Fracture Care (INORMUS; Dr. M. Bhandari) • Prophylactic Antibiotic Regimens in Tumor Surgery (PARITY; Dr. M. Ghert) Pediatric Surgery: • Disability Averted by Pediatric Surgery study (Dr. Poenaru and Dr. Cameron, Kenya).

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Education Groups & Programs

Surgical Teachersâ&#x20AC;&#x2122; Education Program (STEP) Developed by surgeons (Drs. Deepak Dath, Edward Matsumoto, and David Szalay, Dpartment of Surgery), in collaboration with the Program for Faculty Development (PFD) (Dr. Anne Wong, Assistant Dean, PFD/ Department of Anesthesia and Ms. Annette Sciarra, Program Administrator, PFD), the goal of this interactive series of workshops is to address an important, but often overlooked, function of all academic surgeons: how learners are taught in the operating room. The first of three sessions involves an introduction to the many challenges inherent in intra-operative teaching, as well as an examination of some of the teaching techniques, styles, and behaviours currently employed by area surgeons. The second session involves further reflection and group discussion around participantsâ&#x20AC;&#x2122; individual experiences and practices with respect to teaching in the OR. The third and final workshop is focused on principles of intraoperative teaching as they relate to existing theoretical frameworks.

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As of 2017 the EFFORT (EFFective Operating Room Teaching) workshop, builds on STEP and expands it to include Anesthesia and Gynecology. The workshop allows those who teach in complex situations to spend some time assessing their own teaching (May 2017), solving their teaching challenges (Nov 2017), and situating their teaching in the current literature (Feb 2018).

Surgeon Scientist residents with Dr. Sheila Singh at the Surgeon Scientist Dinner 2017.

Education Groups & Programs

Surgeon Scientist Program Under the leadership of its Director, Dr. Sheila Singh, the Department of Surgery’s Surgeon Scientist Program (SSP) facilitates access to high-quality graduate research training for surgical residents and serves to encourage the pursuit of careers in academic surgery. It does this in conjunction with McMaster University’s existing Clinician Investigator Program (CIP). CIP is a Royal College accredited research training program, which offers tuition support and a travel allowance through Postgraduate Medical Education, alignment with research supervisors and other research trainees, Royal College accreditation, additional funding opportunities and the means to seek both internal and external funding, and an academic program relevant to all trainees. The SSP makes use of the already substantial infrastructure available to learners at McMaster in the areas of basic sciences, a world-renowned clinical epidemiology/health research methodology program, and medical education and biotechnology/innovation. It also works to connect research trainees to a wide range of research supervisors who have

elected to participate in the program. The selection of SSP residents is completed via a competition for available MOH-funded (first-year) spots held in the fall of each year, with a selection committee appointed to identify the successful candidates. During the period of SSP research training, which typically consists of 24 consecutive months of research, trainees do not have regular clinical responsibilities and are mostly free from the duties of the clinical stream of residency. However, students do maintain some clinical activities through occasional call coverage, attendance at clinical rounds and teaching sessions, and even specialty clinics, which provide exposure in the trainee’s area of research. Dr. Singh meets with all interested candidates, provides ongoing service as an advisor/mentor and liaison with the CIP, assists trainees in pursuing both internal and external funding sources, in addition to providing an annual series of SSP lectures conducted by faculty surgeon scientists. The program also holds a yearly dinner event designed to focus on the achievements of SSP residents and to thank SSP faculty for their contributions.

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Education Groups & Programs

Surgeon Scientist Program 2015 Cohort Michelle Kameda-Smith (PGY2 Neurosurgery) PhD, Biochemistry Graduate Studies Program, McMaster University Research project: With an interest in basic science research and tumour oncology, Michelle is working in Dr. Sheila Singh’s lab in McMaster’s Stem Cell and Cancer Research Institute. Research supervisor: Dr. Sheila Singh Nazari Dvirnik (PGY3 Cardiac Surgery) Two-year thesis-based Master’s in Health Research Methodology, Department of Clinical Epidemiology & Biostatistics, McMaster University Research project: The overall objective of Nazari’s research project is to reduce the risk of perioperative stroke in cardiac surgery patients, and is based on the hypothesis that stroke is caused by manipulation of the aorta, i.e. cross-clamping during cardiopulmonary bypass. The project will also involve initiating brain MRI imaging to further elucidate the impact of aortic manipulation on thromboembolic events. Research supervisor: Dr. Andre Lamy

2016 Cohort Colm McCarthy (PGY4 Orthopaedic Surgery) MSc Program in Health Science Education, McMaster University Research project: Colm’s thesis will be focused on mentorship and feedback within competence-based evaluation systems, as well as the role of video and written instruction in surgical education. Research supervisor: Dr. Ranil Sonnadara Yuding Wang (PGY4 Urology) MSc Program in Health Science Education, McMaster University Research project: With an interest in medical education, Yuding’s research will be focused on his interest in the field of evaluation and its use as a learning tool. Research supervisor: Dr. Edward Matsumoto

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Funding Highlights: Iqbal Jaffer (HHS New Investigator Fund Award, $37,500) Sophocles Voineskos (MSA Education Research Grant, $28,326, and HHS New Investigator Fund Award, $25,000) Nathan Evaniew (Michael G. DeGroote Fellowship Award in Clinical Research, $40,000; Ontario Graduate Scholarship Award, $15,000; CIHR Frederick Banting and Charles Best Canada Graduate scholarshipDoctoral Award, $35,000 per year for up to three years; and Physicians’ Services corporated Grant, $20,000) Chris Coroneos (CIHR Planning and dissemination Grant, $12,450; CIHR Frederick Banting and Charles Best Master’s Award, $17,500; HHS New Investigator Fund Award, $25,000; Father Sean O’Sullivan Research Centre Award, SJHH, $18,000; and Margaret and Charles Juravinski Fellowship Award, $25,000) Natasha Cohen (Margaret and Charles Juravinski Fellowship Award, $25,000) Scholarship-Doctoral Award, $35,000 per year for up to three years; Physicians’ Services. Incorporated Grant, $20,000)

Education Groups & Programs

One Day Matters (ODM) In the past, there has been considerable discussion across Canada around the significant decrease in applicants for surgery residency positions. While a multitude of factors influence career choices, it is generally believed that the decision-making process begins in earnest during the first year of medical school. The One Day Matters (ODM) program was launched nationally in 2009 by Dr. Susan Reid and, by popular demand, repeated every year since then. The program matched firstyear medical students to both academic and community surgeons over the course of a onemonth period across Canada and included an orientation package, a scrub session, and a day in the Operating Room with their matched surgeon.

A review of the program indicates that the opportunity to spend one day in the OR, especially during the same month as their peers, has not only increased the impact on each student at each site, but has also increased the discussion of experiences among the students at the national level. Feedback has been very positive from both surgeons and medical students and it is anticipated that applications for surgery residency positions in two to three years time will support early indications of the programâ&#x20AC;&#x2122;s success.

The program has matched first-year medical students in general surgery and subspecialties including paediatric surgery, vascular surgery, thoracic surgery, orthopaedic surgery, neurosurgery, cardiac surgery, otolaryngology, and ophthalmology.

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and to facilitate the ability of residents to meet the minimum standards set by the SF Committee. Prior to 2012, the SF Committee (SFâ&#x20AC;&#x2122;s equivalent to the RPC) was resident-led with the only Faculty member attending being the SF Director. Royal College (RC) SF standards have since changed and 2012/2013 saw the introduction of divisional Program Directors and their program assistants participating in quarterly SF Committee meetings and the development of a separate Resident Representatives Group.

Dr. Nalin Amin, MD, FRCS(C) Director June 2009 - Present

Education Groups & Programs

Surgical Foundations Surgical Foundations (SF) has been undergoing and continues to undergo a great deal of change and development. The last three years has seen changes to the structure of the SF Committee, the introduction of gap days, and a much more rigorous approach to SF resident evaluation. Gap Days were introduced to the SF schedule in 2010 to give divisions dedicated academic half-day time for division-specific educational activities, like retreats, objective structured clinical examinations (OSCEs), in training exams, visiting speakers, and so on. This is designed to reduce the number of occasions that residents might be absent from SF academic half-days to attend to other events

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A set of minimum standards and passing criteria for SF residents was initiated early in the Amin directorship and these standards have been implemented with increasing robustness during the directorship resulting in remediation where residents have not met the minimum requirements/standards.

Surgical Foundations & Ob/Gyn Change continued with the enfolding of junior Ob/Gyn residents into SF. Since July 1, 2010, Ob/Gyn PGY1s started auditing SF academic half-days as guests for a one-year program. As of July 1, 2016, residents entering the Ob/Gyn program are mandated by the Royal College to attend SF and write the SF exam. July 1, 2017 will see the start of a double Ob/Gyn cohort for SF PGY1s and 2s participating in the full two-year program.

Competency-Based Medical Education More monumental change continues with the shifting toward the Royal Collegeâ&#x20AC;&#x2122;s

competency-based medical education program (CBME), Competency by Design (CBD). SF is among the second cohort to go live and is currently scheduled to do so July 1, 2018. In preparation for this paradigm shift, a novel boot camp was developed and tested in July 2016 (details below) primarily to prepare entering trainees for residency training and to complete the Surgical Foundations’ Transition to Discipline milestones and entrustable professional activities prior to initiating clinical work.

Collaboration with Office of Education Science SF has partnered with the Office of Education Science (OES) for the transition to CBME. OES has been collaborating with SF to aid implementation of milestones and entrustable professional activities determined by the RC SF Specialty Committee. The RC mandates a “Transition to Residency” phase of training that aims to make the start of residency a smoother transition for learners, faculty, and patients. The “Transition to Residency” phase has been implemented in the form of a twoweek boot camp, the first of which took place during the first two full weeks of July 2016. This novel McMaster Department of Surgery Boot Camp helps rapidly develop a basic skillset utilizing a combination of technical and nontechnical simulation-based activities, workshops, and didactic lectures culminating in an assessment OSCE.

Camp will be an annual event moving forwards given its early success and uptake. The second boot camp will be held from July 3, 2017 to July 14, 2017. Feedback from the first group of residents to go through boot camp was used to modify and improve the second boot camp and will continue to evolve as needs change.

Future Directions Moving forward, SF will continue its work with the OES on the continued implementation of CBD within Surgical Foundations whilst testing and evaluating the evaluative tools developed as the process unfolds.

Surgical Foundations Boot Camp The boot camp was, by all accounts, highly successful. Data analysis by the OES is ongoing in order to explore the effectiveness of the SF Boot Camp. The McMaster Department of Surgery SF Boot

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Dr. Ranil Sonnadara, PhD. Director, Office of Education Science

Education Groups & Programs

Office of Education Science (OES) The mission of the Office of Education Science (OES) is to assist surgical specialties with improving their educational programs at all levels of training, as well as to create and incorporate the best and latest evidence and ideas in Surgical Education. While we provide assistance with many aspects of training, one of our areas of focus is helping McMaster adopt the Royal Collegeâ&#x20AC;&#x2122;s new Competence by Design (CBD) initiative. The OES reports to the Associate Chair of Education, Dr. Stephen Kelly, under the leadership of Dr. Ranil Sonnadara. Dr. Sonnadara brings extensive experience in education research and innovation to this role. His research team includes several graduate students from the Computational Science and Engineering, Health Research Methodology, Health Science Education, and Psychology, Neuroscience and Behaviour programs, and works closely with other educational leads across the University, including in Postgraduate Medicine and in the Program for Educational Research and Development (PERD) within the Faculty of Health Sciences. The OES has several projects on the go. It has partnered with the Division of Orthopaedic Surgery to implement a standardized approach to assessment and feedback across their training program. This work lays the foundation for their transition to CBD in 2020. Alongside the Program Director, Dr. Brad Petrisor, and several staff and trainees, the OES has worked to produce a new suite of

assessment tools that assist learning across different stages of training. These tools are now being pilot tested across the Division. Other projects underway with the Division of Orthopaedics include a new study exploring neural correlates of mind wandering, a study examining the efficacy of video-based training, and a project examining how different learning modalities affect attention and knowledge retention for surgical procedures. The OES has also partnered with Surgical Foundations (SF) and its Program Director, Dr. Nalin Amin. The first project was to develop and implement the SF Boot Camp that was held during the first two weeks of July of 2016. The Boot Camp was designed to provide incoming trainees with an opportunity to improve their medical knowledge, confidence, and procedural and technical skills before beginning their clinical duties. Extensive data collection, including feedback from staff and trainees who participated in the inaugural Boot Camp, has proven essential for the planning of the second annual SF Boot Camp, which is now underway. The OES is continuing to work closely with Dr. Amin and other SF staff to examine the effectiveness of this new training program, as well as to explore other changes to the regular SF curriculum. The Division of Otolaryngology-Head and Neck Surgery (OTL-HNS) is the first surgical training program to make the transition to CBD and will begin accepting residents into its new CBD curriculum starting in July of 2017. In preparation for this, the OES has spent the last few months working with the Program Director, Dr. Diane Reid, and other staff and trainees to develop and implement five new assessment tools

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“...The mission of the OES is to assist surgical specialties with improving their educational programs at all levels of training...”

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that will be used to assess the initial Entrustable Professional Activities (EPAs). This has included facilitated meetings with several off-service rotation specialties to discuss the overlap of program requirements and explore if there are opportunities to use a common set of EPAs and assessment tools across several different training programs. The OES is also helping the OTL-HNS program to implement a new competence committee, which will be an integral component of the program’s transition to CBD. This past year, the OES introduced a new quarterly Journal Club focusing on Surgical Education Research. The Journal Club has had two successful meetings to date, in October 2016 and January 2017, with a third meeting set to take place on April 11, 2017. A new initiative for Fall 2017 is a multidisciplinary Surgical Education Research Symposium, highlighting the diverse, highquality education-related research happening at McMaster and beyond. This event will take place on Wednesday, September 20th, 2017. For more information, please contact info@skillslab.ca. Another project on the go includes the development of a CanMEDS-based assessment tool for grand rounds that will be used across several different divisions. Dr. Sonnadara and his staff have also participated in several external reviews, further assisting in goal-setting for the educational programs of the Department of Surgery. Work has also begun on curriculum development with the Divisions of Cardiac Surgery, Neurosurgery, Vascular Surgery, and Urology. We are always looking for new projects — if you have ideas, feel free to contact us!

Office of Education Science Staff (left-right: Dr. Colm McCarthy, Andrew McGuire, Sabahat Balaban, Nathalee Ewers, Natalie Wagner, Anita Acai, Jeni Zering, Portia Kalun, Maverick Chan)

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Endowed Chairs

Left-Right: Drs. Susan Reid, Yaron Shargall, Mehran Anvari, Jacques Tittley, and Bobby Shayegan.

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Endowed Chairs John A. Bauer Chair in Surgery; held by Dr. Susan Reid, Professor and Chair, Department of Surgery This endowment was provided by the estate of Dr. John Bauer, a prominent Hamilton physician. This fund was put in place to accompany the position of Chair of the Department of Surgery. The Chair is intended to support the Department Chair in pursuit of academic development and scholarship in surgery through clinical work, education, and research, and to address scientific discovery with a vision toward establishing and maintaining a world class Centre of Excellence in Surgery.

The Mortgage Intelligence/GMAC Chair in Thoracic Surgery; held by Dr. Yaron Shargall, Associate Professor and Division Head, Thoracic Surgery This endowment was provided specifically for focused efforts in building and enhancing relationships to create research opportunities to nurture a first-class educational/residency training program in Thoracic Surgery. This Chair frees the Chair holder from the economic consequences of choosing between the pursuit of research and clinical practice, so that the Chair will have a clear mandate and opportunity to oversee and optimize excellence in patient care and provide leadership to the Division and the community.

Chair in Minimally Invasive Surgery and Surgical Innovation; held by Dr. Mehran Anvari, Professor and Director, Ontario Bariatric Network, General Surgery The Chair holder of this endowment is intended to focus on the field of minimally invasive surgery and address a broad and comprehensive range of surgery issues. This Chair is intended specifically to address scientific uncertainty and advancement, and to be an integral part of the institutional vision toward establishing and maintaining a world class centre of excellence in minimally invasive surgery. This Chair holder is also charged with participation in the development, implementation, and evaluation of curricular innovations in both undergraduate and postgraduate medicine.

Braley Gordon Chair in Urology; held by Dr. Bobby Shayegan, Associate Professor, Deputy Chief of Surgery and Division Head, Urology No report is provided for this Chair as Dr. Shayegan has only recently been named Chair holder. The Braley Gordon Chair in Urology was intended to facilitate the development of an academic program in Urology at McMaster University and St. Josephâ&#x20AC;&#x2122;s Healthcare. The Chair holder is intended to act to facilitate the academic and clinical development of this program and the McMaster Institute of Urology, and to facilitate the development of a national profile for the Division of Urology.

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Endowed Chairs Beamish Family Chair in Peripheral Vascular Surgery; held by Dr. Jacques Tittley, Associate Professor, Division of Vascular Surgery This gift was directed to the Faculty of Health Sciences to provide support in research and education in Vascular Surgery at McMaster University. The Chair holder is tasked with making a significant contribution to the body of scholarship in Vascular Surgery through international recognition for contributions in the discipline. The Chair holder will work toward the establishment of a world class Centre of Excellence through development, implementation, and evaluation of curricular innovations in undergraduate and postgraduate medicine. Dr. Jacques Tittley has recently been renamed as Chair holder of this endowment.

Juravinski Thoracic Surgery Professorship; held by Dr. Yaron Shargall, Associate Professor and Division Head, Thoracic Surgery This gift has been directed to St. Josephâ&#x20AC;&#x2122;s Healthcare Foundation to support research interests in the field of Thoracic Surgical Oncology as well as a comprehensive range of Thoracic Surgery. The holder of this contribution is intended to be recognized for contributions in evidence-based care in Thoracic surgery and research contributions in the field.

Dr. Mohit Bhandari and Dr. Sheila Singh Canada Research Chairs

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Canadian Research Chairs Dr Mohit Bhandari Canada Research Chair in Musculoskeletal Trauma and Surgical Outcomes

Dr Sheila Singh Canada Research Chair in Human Cancer Stem Cell Biology

Trauma is the leading cause of death in the first four decades of life surpassed only by cancer and atherosclerosis as the major cause of death in all age groups. For every death attributable to trauma, three patients survive but are permanently disabled.

It was while Dr. Sheila Singh, Canada Research Chair in Human Cancer Stem Cell Biology, was in medical school that two little boys with brain tumours — both named Christopher — sowed the first seeds of her interest in research. Both were five years old and treated with the best current therapies. One flourished. The other passed away.

With over 60 million injuries per year in North America, approximately 50 percent require medical care, of which 8.7 million patients are temporarily disabled. Trauma-related care costs over $100 billion annually. Yet, despite these staggering costs, only four cents for every dollar is spent on trauma research. The care of patients with musculoskeletal injuries has been guided by physician opinion since quality research in this area has been limited. Dr. Mohit Bhandari and his colleagues at McMaster University are changing the paradigm of "eminence-based practice" to "evidence-based practice." In his search for evidence, Dr. Bhandari has been co-leading a collaborative multicentre randomized trial of alternative operative techniques in patients with tibial shaft fractures — the most common long fracture. The study is setting a benchmark in the conduct of orthopaedic trials worldwide. As the Canada Research Chair in Musculoskeletal Trauma and Surgical Outcomes, Dr. Bhandari has developed a research program that meets the need for highquality surgical research aimed at answering clinical questions of international importance. His research includes the design and conduct of large, multicentre randomized trials that evaluate interventions in patients with musculoskeletal injuries. In addition, his program explores the methodological issues specific to the conduct of surgical trials and involves the application and evaluation of evidencebased methods to guide the care of patients with musculoskeletal trauma. In the process, his program is attracting and educating new surgical trainees as career academic surgeons. Source: Canada Research Chairs Chairholders Profiles

Singh says the boy who died left her a legacy of questions: Why should two small boys with the same disease fare so differently? What is different about each individual’s tumour? As a scientist in McMaster University’s Stem Cell and Cancer Research Institute, Singh now spends her life looking for the molecular and genetic answers to these questions. She’s discovered an abnormal stem cell—the brain tumour initiating cell (BTIC) — that may drive the formation of brain tumours. It’s the first isolation of cancer stem cells in the central nervous system — a discovery with important implications for understanding how brain tumours start. Most important to Singh’s research is the idea that only a small population of cancer stem cells, and not every cell in a brain tumour, is capable of generating and propagating. Current approaches to brain tumours focus on every cell in the tumour rather than on the rare tumour stem cell, and this may explain the poor response of brain tumours to current treatments. Future therapies that target the BTIC could better halt the growth and propagation of tumours. Singh and her team will continue to search for better surface markers for the BTIC, making it possible to isolate the cell even more specifically and easily. Her work will offer insight into patient prognosis, as patients with a higher proportion of BTICs may have a shorter survival and worse prognosis. Her studies will form the basis for future trials of therapy directed against the BTIC. Source: Canada Research Chairs Chairholders Profiles

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Cathy Turner, BA(hons), MHS, CHE Director of Administration

A Message from Our Director of Administration I joined the Department as Director of Administration in December of 2012. I feel fortunate to be a part of this dynamic Department and the inspiring leadership of our Chair, Dr. Susan Reid, and Associate Chairs, Dr. Stephen Kelly (Education) and Dr. Mohit Bhandari (Research). Some new initiatives I have particularly appreciated being a part of include the introduction of the Office of Education Science, the expansion of our Office of Surgical Research Services, and the implementation of a focus on communications within the Department. Created in the summer of 2015, as an expansion of the work of Dr. Ranil Sonnadara since 2012, the Office of Education Science is equipped with a very strong team of faculty, graduate and PhD students, and students of all levels, under the direction of Dr. Sonnadara. The initial mandate of the office is to help surgical specialities improve their educational programs at all levels of training. One area of focus has been the Royal Collegeâ&#x20AC;&#x2122;s new Competence by Design (CBD) initiative; within Surgery, Otolaryngology Head & Neck, Urology, and Surgical Foundations are proceeding to CBD first. The Office of Education Science strives to bring the best evidence to education, including, the use of Evaluation Tools, Curriculum Development, and other topics in Educational Research. Dissemination of new knowledge is demonstrated in the Educational Videos in Surgery, regular Education Journal Club; and a new Education Symposium will be offered through the Office of Education Science in the fall of 2017.

The Office of Surgical Research Service has been supporting Surgeons and Surgical Residents with methodology and statistical analysis expertise for a number of years. This year, Director Dr. Forough Farrokhyar has expanded her group and the role of the office to provide Grant Review, Ethics Review, and Communication of Funding Opportunities, with a more diversified team of Support Staff. One of the initiatives that this office has inspired, which brings excellent impact, is the training of New Research Staff. Through a series of seminars and workshops, Dr. Farrokhyar and her team have capitalized on the expert knowledge of some of our senior research staff, to provide technical and practical tips and tricks to junior staff. This initiative has provided strength to Department research expertise quickly. Another exciting development within our Department has been the addition of Communications Coordinators Maria Lee Fook and Blake Dillon. The Department has begun enhancing our outward facing profile through the use of Twitter and Facebook and the launch of our new Department website. To support effective communication in a growing and transforming Department, we have begun enhanced communication with a monthly internal newsletter and we welcome input. Maria and Blake have also worked toward building some exciting video and media campaigns, which we hope will spark a good deal of community interest in the Department and our Surgeons; our Everyday Heroes!

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Some staid and true functions of the Department have remained strong. An extraordinarily active few years in faculty recruitment have been expertly coordinated through Brenda Paine. Terrie Harvie continues to drive our staff safety initiatives, this year including self-defence classes for our staff. Our 100 full-time and over 100 part-time faculty members recieve steady direction and Tenure and Promotion support from Kathy Wilson. Anne Lancaster continues to lead us in support staff recruitment with support of Laurie Dennison. Marcy Murchie has expertly coordinated a centralized Finance service with an expanded team and now employs one fulltime and two part-time Finance Assistants, Ann Kolkin, Tanya Nesvit, and Nick Gervais.

Anne Lancaster Assistant Manager, HR

Finally, we look forward to celebrating the Departmentâ&#x20AC;&#x2122;s 50th Anniversary this year, and hope to see many faculty, alumni, and retired faculty at this years Gala! Stay tuned for more details on that.

Cathy Turner, BA(hons), MHS, CHE Director of Administration

Marcy Murchie Finance Manager

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Your Administrative Team Left to right: Brenda Paine, Maria Lee Fook, Blake Dillon, Katherine Wilson, and Terrie Harvie.

Left to right: Ann Kolkin, Nick Gervais, Tanya Nesvit, Laurie Dennison, and Andrew Folino.

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Division Reports

Department of Surgery Division Heads Cardiac Surgery

Orthopedic Surgery

Dr. Irene Cybulsky

Dr. Mohit Bhandari

General Surgery

Otolaryngology

Dr. Peter Lovrics

Dr. Stuart Archibald

Neurosurgery

Thoracic Surgery

Dr. Sheila Singh

Dr. Yaron Shargall

Pediatric Surgery

Urology

Dr. Brian Cameron

Dr. Bobby Shayegan

Plastic Surgery

Vascular Surgery

Dr. James Bain

Dr. David Szalay

Ophthalmology Dr. John Harvey

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Dr. Irene Cybulsky, MD, MSc, FRCS (C) Division Head, Division of Cardiac Surgery

The Division of Cardiac Surgery The Cardiac Surgery Division at the Hamilton General Hospital site of HHS continues to be amongst the busiest cardiac surgery centres in the province.

34 24 Publications Presentations

1,800

Division Faculty

open-heart cases per year

At a glance... The Cardiac Surgery training program continues to provide tremendous opportunities for residents to acquire technical surcical â&#x20AC;&#x153;cuttingâ&#x20AC;? skills as well as operating in a supportive environment with opportunities for research. In June of 2016, two of our trainees completed their six years residency, successfully sat the fellowship examinations, and went on to pursue their fellowships. Under the directorship of Dr. John Lee, who took over as director shortly after coming to HHS in the spring of 2014, the residency program underwent an internal review in June of 2016 to assess changes in the program after the 2015 Royal College Review. The residency program now includes in its administrative structure a promotional committee, with Dr. Lamy assuming this leadership role. Improvement in resident teaching sessions and their documentation has occurred. There are regular journal clubs and a resident research and education day was held on May 7, 2016, featuring guest speaker Dr. Ranil Sonnadara, who discussed Competency by Design.

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Division of Cardiac Surgery

Clinical Updates

Research

The cardiac surgery division at the Hamilton General Hospital site of HHS continues to be amongst the busiest cardiac surgery centres in the province, performing over 1,800 open-heart cases per year. The division has a complement of eight surgeons, with one surgeon also an intensivist (quarter time). The majority of cases continue to be coronary artery bypasses, most of which are performed with the support of the cardiopulmonary bypass circuit, but some off-pump. A small number of patients requiring single-vessel bypass to the left anterior descending artery had their bypass procedure done with a minimally invasive approach â&#x20AC;&#x201D; through a small left thoracotomy incision. Minimally invasive surgery has recently also expanded to the aortic valve. In patients with suitable anatomy, Dr. Dyub has successfully used a five-centimetre incision below the second rib to access the aorta and replace the valve, allowing patients to be discharged home sooner, with less postoperative pain. Dr. Chu has significant experience with the small right thoracotomy approach to the mitral valve.

The division is involved in numerous research studies, including multicentre prospective randomized studies. Two such studies have recently been completed and their results published in NEJM and The Lancet.

At HHS, the transcatheter aortic valve implantation (TAVI) program has grown in volume and participation with three cardiac surgeons and three interventional cardiologists presently involved in the implants. Last year, 100 such valves were implanted, most transfemorrally, with a few transapically. Likewise, in collaboration with interventional cardiology, the transcatheter approach has been used to implant Mitral clips. In addition, Dr. Parry continues to work with the Eletrophysiology service to perform laser lead extraction for infected or recalled pacemaker or defibrillator leads. A limited assist device program to support the left ventricle with the Impella assist device is also active.

Dr. Lamy has completed the CORONARY study â&#x20AC;&#x201D; CABG off or on-pump revascularization study. This study was the largest study to date that compared the two techniques of coronary bypass. 4,752 patients were randomized in 79 centres in 19 countries. Initial results were published in 2012, showing no difference in perioperative death or myocardial infarction. There was less need for transfusion in the off-pump group and a slightly higher need for early revascularization. The most recent fiveyear outcomes were published in NEJM in December of 2016, showing both groups having similar outcomes. This study has established the safety of off-pump surgery. Dr. Lamy is the surgical lead at HHS on the multicentre COMPASS study, A Randomized Controlled Trial of Rivaroxaban for the Prevention of Major Cardiovascular Events in Patients with Coronary or Peripheral Artery Disease (COMPASS-Cardiovascular Outcomes for People using Anticoagulation Strategies). Recruitment for this study is now complete, and patient follow-up is ongoing. In addition, Dr. Lamy is involved in a phase II study of an agent whose purpose is to mitigate acute kidney injury in patients undergoing cardiac surgery. Dr. Lamy supports research work of allied health professionals and has advised nurse practitioners. One project culminated in

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I. Travale’s presentation of a pilot study looking at the prophylactic use of Haloperidol in patients at risk for delirium, at the Canadian Cardiovascular Congress, Oct 2016.

of patients into the TRICS (Transfusion Requirements in Cardiac Surgery) study to assess whether a liberal or conservative transfusion practice is beneficial.

Dr. Whitlock completed the SIRS study – Steroids in Cardiac surgery trial. It examined if low-dose steroid treatment might be beneficial in mitigating the inflammation syndrome associated with cardiopulmonary bypass and improve outcomes after cardiac surgery. This study recruited 7,507 patients in 80 centres, in 18 countries over six-and-a-half years. The findings were published in The Lancet in September of 2015. The study showed that there is no benefit to adding steroids in cardiac surgery patients.

We are currently in the process of joining the Cardio-Thoracic Surgery Network as a recruitment site and participating in the multicenter study titled “Evaluating the Benefit of Concurrent Tricuspid Valve Repair during Mitral Surgery.”

Dr. Whitlock’s ongoing clinical research is focused on the left atrial appendage, as to whether excision of the appendage in patients with atrial fibrillation will have a beneficial impact on stroke prevention. Dr. Whitlock has numerous publications on this subject including most recently an article in Circulation 2015, reviewing the current status of atrial appendage occlusion and the impact of new anticoagulants now available.

Whitlock et al SIRS Investigators. Methylprednisolone in patients undergoing cardiopulmonary bypass (SIRS): a randomised, double-blind, placebo-controlled trial. Lancet. 2015 Sep 26;386(10000):1243-53.

Dr. Whitlock holds numerous grants for the multicentre LAOS III study — Left Atrial Appendage Occlusion Study, where patients are randomized intraoperative as to whether the surgeon will occlude the left atrial appendage. All surgeons at HHS participate in this study. A large prospective study involving data collection and measurement of cardiac biomarkers in the setting of cardiac surgery (VISION, Cardiac) is in progress with Dr. Lamy, Dr. Whitlock, and PHRI support from Dr. Devereux. Our centre is known for successful recruitment of patients into studies. Currently, cardiac surgeons are supporting enrollment

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Research Highlights Lamy et al N Engl J Med 2016; 375:23592368 December 15, 2016

Whitlock RP, Healey JS, Holmes DR. Left atrial appendage occlusion debate revisited. Circulation. 2015 Feb 24;131(8):756-61. Jaffer IH, Fredenburgh JC, Hirsh J, Weitz JI Medical device-induced thrombosis: what causes it and how can we prevent it? J Thromb Haemost. 2015 Jun;13 Suppl 1:S72-81 McClure GR, Belley-Cote EB, Singal RK, Jaffer IH, Dvirnik N et al, Surgical ablation of atrial ﬁbrillation: a protocol for a systematic review and meta-analysis of randomised controlled trials, BMJ Open 2016;6:e013273. doi:10.1136/bmjopen-2016-013273 Alsagheir A Patlas M, Farrokhyar F, Parry D, Ascending Aortic Elongation is a Predictor of Aortic Dissection, presented CCC, Montreal Oct 22 2016 abstract: Canadian Journal of Cardiology, Vol. 32, Issue 10, S113–S114

Division of Cardiac Surgery Faculty Dr. Richard Whitlock (left) received the Department of Surgery Chairs Award for Distinction in Research. To his left: Dr. Cybulsky (Division Head), Dr. Dyub, Dr. Lamy, and Dr. Lee (Program Director).

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Dr. Peter Lovrics, MD, FRCS Division Head, Division of General Surgery

The Division of General Surgery The Division of General Surgery prides itself on its commitment to teaching, at the undergraduate, postgraduate and faculty levels. As one of the largest residency programs within the Department of Surgery, the division facilitates the education of 41 residents.

34 Publications

26 Full-time Faculty

24 Presentations

At a glance... The Residency Program, led by Dr. Michael Marcaccio - Program Director, is highly regarded and consistently produces graduates that provide high quality community surgical care throughout the country, as well as graduates that go onto subspecialization and academic careers. Division members are active in undergraduate education through the Degroote School of Medicine, as tutors, elective supervisors, research supervisors as well as providing faculty support to the Undergraduate Surgery Interest Group and participation in the One Day Matters initiative. Dr Nalin Amin is the Director of the Surgical Foundations program, which is a key component of resident education at McMaster. Division members also play very active roles at the Royal College. The Centre for Minimal Access Surgery (CMAS) program has been an international leader in the training and mentoring of surgeons in minimal access surgery (MIS), and also provides this expertise to McMaster residents and fellows. The Division offers Royal College accredited Fellowships in MIS and Breast oncology. The Surgical Outcomes Research Centre (SOURCE) also provides surgeons in the region with educational opportunities through workshops and key publications on Surgical Research.

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The Division of General Surgery at the 2014 Alumni Gala.

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Division of General Surgery

Research

Future Directions

The Division of General Surgery is actively involved in research. Majority of the research is based within the Division, but there is also great collaboration with our partners at McMaster, both in Clinical Epidemiology and Basic Sciences, and with the newly established link with the Institute for Clinical Evaluative Sciences (ICES). CMAS has been a world leader in MIS research, including tele-surgery and is currently actively involved in Robotics development, led by Dr. Mehran Anvari. The Division also supports a productive Clinical Scholar program, where Fellowship trained surgeons are able to complete post-graduate degrees combined with valuable clinical experience in surgery.

The Division looks toward the future and the questions facing all surgeons. How can we improve the processes of care? How will teaching students and residents evolve as technological changes accelerate? Where will the next area of cutting edge research be? We plan to embrace these challenges and look forward to the success of our division and Department of Surgery.

The Division is a national international leader in outcomes research and Knowledge Translation, with particular strengths in Colorectal and Breast Oncology research. There are also active projects on novel surgical technologies, randomized trials, population-based studies collaborative work with our partners in the basic sciences. A major focus has been successful projects in region-wide quality improvement projects, that have combined research and education with partnerships with our colleagues throughout the region. The Division also has a very productive MIS Research Collaboration, which has numerous research foci, including Bariatric surgery. Finally, research strengths are developing in Hepatobiliary Surgery, Trauma and Acute Care Surgery. Research is crucial to the education of our residents. Our annual resident research day highlights the innovative work of our residents with their faculty supervisors. Residents are required to complete two research projects during their residency.

The Division has a successful past that we are very proud of. A large part of this includes the highly collegial relationships amongst Division members. Members work well together in all aspects, partnering to provide clinical service, education and research. We will continue to host our annual Division social events, such as the Divisional Dinner, the AK Mighton Golf Tournament and Divisional retreats.

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Dr. Sheila Singh, MD, PhD, FRCS(C) Interim Division Head, Division of Neurosurgery

Publications

Presentations

Division Faculty

At a glance The division of neurosurgery at Hamilton Health Sciences serves a catchment area of over 2.5 million people, and represents the second-largest academic neurosurgery service in Ontario. We provide a broad range of clinical neurosurgical services, and are currently comprised of eight faculty members (five adult neurosurgeons, two non-GFT and three GFT, based at the Hamilton General Hospital, and three pediatric neurosurgeons based at McMaster Childrenâ&#x20AC;&#x2122;s Hospital), one clinical scholar and two clinical locums. The division educates a range of students from undergraduate to medical students, residents and clinical fellows, and our Royal College accredited neurosurgical residency program is growing. The HHS division of neurosurgery carries a very high clinical caseload and delivers excellent round-the-clock patient care through CritiCall to Ontarians in our catchment area and beyond, providing a large number of teaching cases for residents and fellows. We also offer spine and neuroendovascular training fellowships. Our research focus is developing in two broad directions: basic and translational neuro-oncology research conducted in the laboratory of Dr. Sheila Singh at the McMaster Stem Cell and Cancer Research Institute.

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From Left: Mohammed Aref, Dr. Olufemi Ajani, Dragos Catana, Mazen Al Otaibi, Kaiyun Yang, RenĂŠe Kennedy, and Nirmeen Zagzoog.

Division of Neurosurgery

Research Updates Our residents are actively engaged in research projects throughout their residency. Resident projects vary across the field of neurosurgery, with current projects focused on carotid endarterectomy, glioblastoma, subarachnoid hemorrhage, and minimally invasive surgery techniques, to identify a few. Each fall, our residents and students present their completed or ongoing research projects at our Annual Neurosciences Research Day. At our 2016 Research Day, two of the top three prizes were awarded to neurosurgical projects. The neurosurgery team runs many local studies and participates in several notable national and international research studies. We are participating in multiple neurovascular trials, led locally by Dr. Almunder Algird and Dr. Brian van Adel, including evaluation of endovascular coiling treatments (HEAT: New Generation Hydrogel Endovascular Aneurysm treatment Trial and DELTA: Does Embolization with Larger coils lead to better Treatment of Aneurysms trial) and transfusion thresholds in aneurysmal subarachnoid hemorrhage patients (SAHaRA: Aneurysmal SubArachnoid Hemorrhage â&#x20AC;&#x201C; Red Blood Cell Transfusion and Outcome). With the success of these trials and the growth and advancement of our neurovascular and interventional team, we are continuing to be involved in further important trials. Dr. Kesh Reddy, Dr. Almunder Algird, and Dr. Sunjay Sharma lead our neuro-critical care and neurotrauma research programs with a focus on traumatic brain injury and intracerebral hemorrhages. This includes participation in TBI-Prognosis and MISTIE III (Minimally Invasive Surgery Plus rt-PA

for Intracerebral Hemorrhage Evacuation Phase III), upcoming participation in RESCUE-ASDH (Randomised Evaluation of Surgery with Craniectomy for patients Undergoing Evacuation of Acute SubDural Haematoma), and involvement in Tsi-TBI (Transfusion strategies following TBI). Dr. Sunjay Sharma is also involved in the development of the following trials: Timing of Warfarin Initiation following Traumatic Brain Injury (TWIN); Timing and Safety of DVT Prophylaxis in Traumatic Brain Injury; and The NEUROlogically-impaired Extubation Timing Trial (Neuro-ETT). Dr. Reddy also focuses on minimally invasive and skull base surgery techniques. Our spinefocused surgeons, Dr. Aleksa Cenic and Dr. Edward Kachur, are continually working to provide evidence-based improvements to surgical techniques and post-operative patient care. Recently, Dr. Kachur has been involved in the development of a myelopathy scale, which has been well-received internationally. Dr. Cenic is working on improving and standardizing postoperative care and preventing infection following lumbar spine surgery. Dr. Naresh Murty and Dr. Sheila Singh focus their research efforts on neurooncology with focuses on adult and pediatric, respectively. Along with Dr. Singh, Dr. Blake Yarascavitch and Dr. Olufemi Ajani are part of the Pediatric Brain Tumour Study Group, where they guide students through research projects. In addition to Dr. Singhâ&#x20AC;&#x2122;s clinical research, she runs a series of impressively funded lab studies

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on glioblastoma, medulloblastoma, and brain metastases. Our clinical locums, Dr. Ahmed Al Jishi and Dr. Saleh Almenawer are also actively involved in the division’s research, working with staff, residents, and students on several systematic reviews, meta-analyses, and case reports. Dr. Al Jishi has also been involved in the development of our neuromodulation program, including research endeavours. Our newly re-established Neurosurgery Research Committee is focused on uniting all of our research interests and resources to continue to develop and investigate novel research questions and move from participatory to leadership roles in our involvement with external clinical trials. Through our increased involvement and enrollment in clinical trials in 2015 and 2016, we have built our reputation as a productive research centre and have been a top recruiting centre in several trials.

Division of Neurosurgery

Education Highlights The Neurosurgery Program at McMaster University recruited three new residents: Radwan Takroni (PGY1 Sponsored), who started in May of 2016 and completed his PEAP on June 30, 2016; Robert Power (PGY2), a transfer from NOSM who will start July 1, 2016; and Michel Sourour (CaRMS PGY1), who will start July 1, 2016. Renee Kennedy transferred to Family Medicine at McMaster. Tarek El Madhoun (Spinal Neurosurgery) began a fellowship in Spinal Neurosurgery October of 2015 and Waleed Alsunbul (General Neurosurgery) has secured a fellowship with us beginning July 1, 2016.

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Neuropathology Day – Symposium joint with Pathology, Neurosurgery supported guest speaker Dr. B. K. Kleinschmidt-DeMasters, Head of Neuropathology at the University of Colorado, on September 11, 2015 in the David Braley Auditorium at Hamilton General Hospital. M. Kameda-Smith presented a talk entitled “Diagnostic dilemma: development of atypical teratoid/rhabdoid tumour in preexisting meningioma or INI1-negative anaplastic rhabdoid meningioma in a child” and R. Baweja presented a talk entitled “Unusual suprasellar tumours.” Neuro-Ophthalmology Day November 27, 2015 — Organized by Paediatric Neurology. Residents attended in lieu of regularly scheduled academic half-day. Minimally Invasive Skull Base Surgery Course April 15 & 16, 2016 — MUMC Anatomy Lab, Organized jointly by K. Reddy and D. Sommers. Neuroscience Symposium — Ethical Clinical Controversies That Keep Us Up At Night. Case-based Discussions held on May 13, 2016 at the Waterfront Centre, at which our chief resident, D. Catana, presented.

Neurosurgery residents enjoy their 2016 Christmas lunch.

2015 Resident Retreat held at the Hamilton Yacht Club

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Dr. Brian Cameron, MD, DipMedEd, FRCS(C) Division Head, Division of Pediatric Surgery

Publications

Presentations

At a glance... The McMaster Division of Pediatric Surgery is recognized as a Canadian leader in minimal access surgery, surgical education, and patient outcomes. McMaster Childrenâ&#x20AC;&#x2122;s Hospital serves a population of 2.4 million people in southern Ontario. We are the sole tertiary pediatric and Level 1 Trauma Center in the area. Moreover, we have one of the largest and most modern Neonatal Intensive Care Units in Canada. Our Nurse Practitioner works closely with our faculty and residents to provide the best care for our complex patients. The educational contributions of Division members to undergraduate, graduate, and postgraduate education in the Faculty of Health Sciences are exemplary. We mentor dozens of residents each year from general surgery, pediatrics, urology, plastic surgery, and anesthesia training programs. Our accredited pediatric surgery training program consistently attracts the best Fellows. We have trained pediatric surgeons who are caring for children in Canada, Saudi Arabia, Kuwait, and Puerto Rico. The McMaster Pediatric Surgery Research Collaborative consistently produces high-quality research and participates in international clinical trials. Our faculty serve as leaders in national professional societies including the Pediatric Surgical Chiefs, the Canadian Association of Paediatric Surgeons, and the Royal College of Physicians and Surgeons of Canada. Our surgeons have unique training, clinical interests, and professional contributions that contribute to our recognition as an innovative, collaborative and forward-thinking Division. We work as a team aspiring to deliver the very best pediatric surgical care for our patients.

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Dr. Mark Walton visiting Kuwaiti pediatric surgeons who are alumni of McMaster. From left: Dr. Amar Alnaqi (2016), Dr. Wasmi Al-Fadhli (2007), Dr. Abdullah Rajab (2011).

The pediatric surgery group with Visiting Professor Dr. Richard Keijzer (back left) and division founder Dr. Gordon Cameron (left).

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Division of Pediatric Surgery

Education Our two-year Pediatric Surgery fellowship program renewed full accreditation in 2015, and we participate in the North America-wide Pediatric Surgery Match with one new fellow accepted each year. Our 2015 and 2016 fellows both successfully passed their Royal College Certification examinations. Dr. Lisa VanHouwelingen then went on to a two-year fellowship in pediatric surgical oncology at St. Jude’s Hospital and will be returning to McMaster as faculty in July of 2017. Dr. Amar Alnaqi has returned to an academic pediatric surgery position in Kuwait. Our division supervises elective rotations for postgraduate trainees (38 in 2016-17) from the general surgery, pediatrics, urology, plastic surgery, and anesthesia programs, in addition to welcoming undergraduate and visiting elective students. The annual Dr. Gordon S. Cameron Visiting Professorship continues to be a highlight of the year and includes Surgical Chair Rounds and Pediatric Grand Rounds. We welcomed Dr. Andrew Davidoff from Memphis as the Visiting Professor in 2015, and Dr. Richard Keijzer joined us from Winnipeg in 2016. Pediatric surgeon Dr. Geoffrey Blair from Vancouver delivered Surgery Chair Rounds in February of 2016 on the role of Pediatric Surgical Camps in Uganda. Our Adjunct Faculty include Dr. Dan Poenaru (Montreal/Kenya) and Dr. Khalid Al-Harbi (Saudi Arabia).

Research The McMaster Pediatric Surgery Research Collaborative (MPSRC) is supported by the McMaster Children’s Hospital Foundation and led by pediatric urologist Dr. Luis Braga. It has a focus on producing high-quality evidence-based research. The pediatric surgeons fund a full-time Research Assistant and have won two new competitive McMaster Surgical Associates grants in 2015-16.

Research Highlights Siddiqui A, Tse A, Paul JE, Fitzgerald P, Teh B. Postoperative epidural analgesia for patients undergoing pectus excavatum corrective surgery: a 10-year retrospective analysis. Local Reg Anesth 2016 May 25;9:25-33. Poenaru D, Pemberton J, Frankfurter C, Cameron B. Quantifying the disability averted through pediatric surgery: a cross-sectional comparison of a pediatric surgical unit in Kenya and Canada. World J Surgery 2015 Sep;39(9):2198-206. Livingston MH, Cohen E, Giglia L, Pirrello D, Mistry N, Mahant S, Weinstein M, Connolly B, Himidan S, Butter A, Walton JM. Are some children with empyema at risk for treatment failure with fibrinolytics? A multicenter cohort study. J Pediatr Surg 2016;51(5):832-7. Bailey K, Cunningham C, Pemberton J, Rimas H, Morrison KM. Understanding academic clinicians’ decision making for the treatment of childhood obesity. Child Obes 2015;11(6):696-706 Flageole H, Pemberton J. Post-Operative Impact of Nasogastric Tubes on length of stay in infants with pyloric Stenosis (POINTS): a prospective randomized controlled pilot trial. J Pediatr Surg 2015 Oct;50(10):1681-5

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During 2015-16, division members presented research and invited papers at national and international meetings in Canada, China, Japan, Guyana, and Uganda. Key areas of faculty research interest are surgical education, quality improvement, pediatric obesity, burden of pediatric surgical disease, quality of life, and trauma. Dr. Michael Livingston won the Canadian Association of Paediatric Surgeonsâ&#x20AC;&#x2122; Best Podium Presentation prize for the third year in a row. Mike is completing his general surgery residency at McMaster and will be our new fellow in July of 2017.

Dr. Khalid Al-Harbi

An RCT of treatment for premature bowel dysmotility is currently underway and we participate in multicentre RCTs of fibrinolytic therapy for empyema and pediatric topical hemostatic agents. We lead and contribute patients to national prospective pediatric surgery databases of gastroschisis, diaphragmatic hernia, and biliary atresia (CAPSNet and CBAR). Our research output for 2015-16 included 30 oral, abstract, and poster presentations with 32 manuscripts and abstracts published.

Milestones Dr. Michael Livingston

Dr. Karen Bailey returned from maternity leave in March of 2016 after delivering her delightful daughter Abigail. She resumed her role as Pediatric Trauma Director, has joined the Hamilton Integrated Research Ethics Board, and was promoted to Associate Professor in July of 2016. Dr. Mark Walton stepped down from the Assistant Dean PGME position after 10 years of service, and continues as Vice-Chair of the Royal College Specialty Committee in Pediatric Surgery. He was nominated for the 2015 PARO Lois H. Ross Resident Advocate Award. Dr. Peter Fitzgerald completed a two-year term as President of the Canadian Association of Paediatric Surgeons and continues in his ninth year as President of McMaster Childrenâ&#x20AC;&#x2122;s Hospital. He Chairs the Canadian Association of Pediatric Health Centres.

Dr. Lisa Van Houwelingen

Dr. Lisa Van Houwelingen will be starting as an Assistant Professor in July of 2017.

Dr. Helene Flageole is the Chief of Pediatric Surgery at McMaster Childrenâ&#x20AC;&#x2122;s Hospital and Chair of the Pediatric Surgical Chiefs of Canada. She continues to lead our fellowship program as Program Director. Dr. Flageole recently completed the Advanced Helath Leadership Program at the Rotman School. Dr. Brian Cameron is Academic Division Head and CTU Director, and leads the departmental International Surgery Desk. Dr. Cameron recently completed a postgraduate Diploma in Medical Education through the University of Dundee.

Dr. Cameron visiting pediatric surgeon Dr. Marisa Seepersaud in Guyana (November 2016)

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Dr. Karen Bailey being promoted to Associate Professor at the Department of Surgery RAVE.

Division of Pediatric Surgery

Future Direction We completed a rigorous recruitment process and are pleased that Dr. Lisa VanHouwelingen has accepted a full-time appointment as Assistant Professor in the Division of Pediatric General Surgery, starting in July of 2017. Dr. VanHouwelingen is completing a two-year fellowship in pediatric surgical oncology at St. Jude’s Children’s Research Hospital in Memphis, as well as an MPH through the University of Memphis. Lisa did her pediatric surgery fellowship with us here at McMaster from 201315 after completing general surgery training in London. In addition to her expertise in children’s oncology, Dr. VanHouwelingen brings a keen interest in multicenter collaborative research. Lisa will be warmly welcomed back by our staff and patients, along with her husband Jesse and two daughters, Ava and Claire.

Dr. Andrew Davidoff, McMaster Visiting Professor 2015 STATUS REPORT

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Dr. James Bain, MD, MSc, FRCS Division Head, Division of Plastic Surgery

Publications

Presentations

At a glance... The Plastic Surgery Division had an excellent year despite challenges of resource limitations and manpower changes. Welcome to both Dr. Matthew and Mark McCrae as a permanent recruits to the team. They bring expertise in hand surgery, microsurgery, and breast reconstruction to add to St. Joseph’s Healthcare. We have further changes coming to this site as Dr. Achilles Thoma will be slowing down clinically but is still a “research tour de force.” Resources for new surgeons is our greatest challenge. Our excellent residents and fellow enriched both the clinical and research productivity of the Division. We had numerous presentations at national and international meetings. We remain committed to excellence in clinical care, education and re-search and plan to grow and create opportunities to further strengthen our Division in the upcoming year. Plastic Surgery is pivotal in the reconstruction and repair of injury, burn trauma, and birth defect victims in our community. The dedicated Surgeons at the Division of Plastic Surgery at McMaster tirelessly endeavour to improve patient care, guided by evidence-based methodologies and innovations. Based at two main teaching hospitals — Hamilton Health Sciences (HHS), a four-site acute care teaching hospital that is Ontario’s largest comprehensive provider of health services, and St. Joseph’s Healthcare Hamilton (SJHH) — the Division is an international leader and educator of evidence-based plastic surgery, spear-headed by our Director of Research, Dr. Thoma. Our residency program continues to attract stellar applicants who diligently participate in weekly teaching rounds, monthly journal clubs and comprehensive didactic programs that stimulate learning. We will continue to recruit and to maintain a high-quality residency program, and continue to provide excellent surgical care to our community and beyond.

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Dr. Achilles Thoma, MD, FRCS (C), FACS Director of Research, Division of Plastic Surgery

Division of Plastic Surgery

Education

Research

Our residency program continues to attract numerous applicants through the Canadian Residency Matching Service (CaRMS) and we look forward to interviewing candidates for the upcoming academic year. Our 16 residents continue to contribute to clinical care, research and education. Diligent attention to the program has paid off and resulted in full approval. Our strong academic program, with weekly teaching rounds, monthly journal clubs, and comprehensive didactic programs, stimulate learning for the residents, students, and staff. Collaboration has proven a great way to offer our learners additional educational opportunities, and this was the case recently as our staff contributed to the biannual MacHAND CME program with orthopedics, physical medicine and rehabilitation, and the members of rehabilitation sciences faculty.

Members of McMaster’s Division of Plastic Surgery are involved in both clinical science research as well as pure basic science research. The focus of clinical science research is in systematic reviews and randomized controlled trials. Patient-related clinical science research is conducted at all sites. The focus of basic science research is in peripheral nerve regeneration. Our Division is recognized as a leader in evidencebased plastic surgery.

Congratulations to the recipient of the 2016 International Surgery Desk Resident Scholarship, Dr. Noor Alolabi (PGY4 Plastic Surgery). Noor plans to take part in a volunteer medical mission with Dr. Carolyn Levis and the Guatemala Healing Hands Foundation this November.

Resident research productivity has been excellent over the last number of years. Residents present their research at the annual Plastic Surgery Research day. This year’s Resident’s Research Day is scheduled for September 29, 2017. All avenues of research are supported by faculty, however, there is particular interest in health outcome measures as we are fortunate to have a worldrenowned faculty in Health Research Methodology at McMaster.

Dr. Ronen Avram Residency Program Director, Division of Plastic Surgery STATUS REPORT

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Dr. Achilleas Thoma was awarded the Canadian Society of Plastic Surgeons 2016 CSPS Lifetime Achievement Award.

Dr. Mark McRae (pictured above) and his twin brother Dr. Matthew McRae were recruited to join the St. Josephâ&#x20AC;&#x2122;s Healthcare team.

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Dr. Carolyn Levis (Associate Professor, Plastic Surgery, McMaster University) presented with an Award of Merit (Order of Princess Olga) by Peter Poroshenko, President of Ukraine.

Division of Plastic Surgery

Milestones We are fortunate to have recruited Dr. Matthew McRae to join the St. Joseph’s Healthcare team. Dr. Matthew McRae’s medical school training was completed at Yale University School of Medicine and included a Masters of Health Sciences degree for translational research investigating clinical biomarkers in melanoma. He completed his plastic and reconstructive surgery residency training at the University of Toronto. Dr. Matthew McRae also completed a hand and reconstructive microsurgery fellowship at the esteemed Buncke Clinic in San Francisco. We are thrilled to welcome him to our team. To complete the team, we also recruited Dr. Mark McRae (Matt’s twin brother). Dr. Mark McRae began with a six-year residency at NYU, Bellevue hospital, and Memorial Sloan Kettering. After residency, he completed a one-year adult craniofacial surgery fellowship at U of T. Following this, Dr. Mark McRae was staff surgeon at St Michael’s, where he performed complex trauma and craniofacial reconstruction. Dr. McRae was a core member of the team that performed the first hand transplant in Canada last year. With a graduate degree in medical education, we hope to have Dr. McRae involved in the implementation of Competency by Design in our division.

Dr. Thoma also received The PSI Foundation grant for the research project entitled, “A multi-centre, randomized controlled trial comparing the clinical effectiveness and costeffectiveness of collagenase injection (Xiaflex) and palmar fasciectomy in the management of Dupuytren’s disease.” Dr. Carolyn Levis (Associate Professor, Plastic Surgery, McMaster University), was presented with an Award of Merit (Order of Princess Olga) by Peter Poroshenko, president of Ukraine, for her work with the Canada Ukraine Foundation medical mission team. Dr. Dal Cin has been appointed the Co-Chair of the Education Committee developing the new Health MBA at McMaster University. She is working with the DeGroote School of Business and Faculty of Health Sciences. Dr. Martin has been selected as a Royal College examiner in 2015/2016 along with Dr. Strumas, and Dr. Levis, our Fellowship Director, will continue to contribute to the Royal College as an examiner.

The Canadian Society of Plastic Surgeons awarded its 2016 CSPS Lifetime Achievement Award to Dr. Achilleas Thoma. This award honors members of the CSPS who have made outstanding contributions to the profession and to the Society.

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Dr. John Harvey, MD, FRCS(C) Division Head, Division of Ophthalmology

The Division of Ophthalmology Dedicated to providing comprehensive eye care and quality training for clerks, residents, and fellows. We have a strong commitment to education with a primary focus on undergraduate and postgraduate surgical training.

16 Publications

53 Presentations

At a glance... Our residency program is newly under the direction of Dr. Enitan Sogbesan and continues to produce excellent graduates. Some have gone into practice and others have entered fellowships. We have one fellowship program in Oculoplastic surgery, supervised by Dr. Yasser Khan. The two fellows will finish their one-year fellowship training next June. The Stringer Day in Ophthalmology, our annual event, was held in Niagara-on- the-Lake on June 4, 2016 and was a huge success. The caliber of presentations was superb. In addition, Dr. Sabri, paediatric ophthalmologist, organized an international symposium on retinopathy of prematurity, which was held in Toronto, Ontario on September 16-17, 2016. The conference attracted participants from all over the world to hear the international lineup of speakers. Weekly rounds, academic half-days, and monthly journal clubs are the backbone of our educational framework. We have a strong interest in ophthalmology amongst undergraduate learners and our elective program is very well subscribed. 160 medical students attend the comprehensive clinical skills teaching program over a three-month period. The four-hour sessions help students who are interested in learning how to carry out a proper eye exam.

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Division of Ophthalmology Resident Laura Donaldson and Faculty Dr. Gloria Isaza during a wetlab.

Division of Ophthalmology

Research Growth We continue to accentuate research in our division. We have perceived this to be a weakness in the past and are working to increase our productively in this area. Residents are required to complete one major research project throughout the course of their residency. Under the direction of Dr. P. Harvey, research coordinator, monthly research rounds encourage and provide ongoing research opportunity and support to our trainees. The Division hosted its Second Annual Research Day on February 24, 2016. Faculty and residents gathered to learn about the ongoing research taking place within the division. Both residents and faculty presented their research projects. The dinner and awards ceremony followed at the Hamilton Golf and Country Club. Dr. Manreet Alangh (PGY5) was awarded the Dr. Jeff Sher Resident Research award. A special thank you to Drs. P. Harvey and K. Sabri for their time and dedication in planning this successful event and to Novartis for sponsoring it.

Resident Chris McLaughlin and Faculty Dr. Enitan Sogbesan during a wetlab.

Awards & Achievements The 2016 Resident Awards: • Cataract surgical teacher of the year: Dr. Beattie • Non-Cataract surgical teacher of the year: Dr. Y. Khan • Resident Appreciation Award: Dr. Ahuja • Clinical teacher of the year: Dr. Rodriguez

• Paediatric Neurology Teaching Award: Dr. A Rodriguez • HHS Medical Staff Association Humanitarian Award for Community and Global Service: Dr. J Harvey (Shared with Dr. Norm Buckley)

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Dr. Mohit Bhandari, MD, PhD, FRCS(C) Division Head, Division of Orthopaedic Surgery

10 188 Publications

Fellowships Foot and Ankle, Trauma, Oncology, Arthroplasty Sports Medicine Upper Extremity

202 Presentations

At a glance... The Division of Orthopaedic Surgery at McMaster University has a history of excellence in Orthopaedic research and education. Our strategy is simple: to be responsible to our patients by providing exemplary patient care, using the best evidence to guide our decisions, and leading innovation in education and research. We aim to be a top-tier program in Canada for evidence-based Orthopaedic training, attracting the best and most promising students to our Division. As a research institution, we endeavor to be the best environment for clinical research, fostering global collaborations, conducting high-impact clinical research, and educating exceptional students at the undergraduate and graduate levels. We seek to attract and retain top national and international Orthopaedic faculty. We will ensure that our facultyâ&#x20AC;&#x2122;s accomplishments are recognized and promoted. The success of our Division is highly dependent upon the unified core values and culture within our leaders. We will continue to produce lifelong learners that practice orthopaedic surgery in a responsible, ethical, and evidence-based manner.

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Division of Orthopaedic Surgery Faculty & Staff at the Department of Surgery RAVE 2016

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Division of Orthopaedic Surgery

Education Our resident Program Director and Coordinator continue to develop collaborations with the Research and High Performance Computing team with Dr. Ranil Sonnadara and are creating specific procedural-based competencies and evaluation tools that will be used to transition to the Royal College’s Competency by Design (CBD) initiative. The program has remained active again this year at the Royal College ICRE conference. Dr. Brad Petrisor was responsible for running the “New Program Directors Workshop” at the conference.

Education Highlights Filled four CMG CaRMS Positions commencing July 1 2015. Nathan Evaniew, PGY3 resident, is due to complete the CIP/SSP in June of 2016 Fellowships for 2015-2016 1: Foot and Ankle 3: Trauma 1: Oncology 2: Arthroplasty 1: Sports Med 2: Upper Extremity

Research Highlights for 2015 - 2016 • Featured as the number one most read article in 2015 by the COA: Arthroscopic Surgery for Degenerative Tears of the Meniscus: A Systematic Review and Metaanalysis; Moin Khan, Nathan Evaniew, Asheesh Bedi, Olufemi R. Ayeni, Mohit Bhandari • Dr. Mohit Bhandari - $7M foundation grant awarded CIHR for Advancing the Care of Patients with Musculoskeletal Injuries Worldwide through Multi-National Research Initiatives. • Dr. Michelle Ghert’s Prophylactic Antibiotic Regimens in Tumor Surgery (PARITY) trial opened its first European site to Enrollment and reached 25% enrollment target in 2016 • Ongoing Research Trails: FIRST, PARITY, FAITH, HEALTH, INORMUS, FLOW • Final publication count complete to June 30, 2016 as captured by PubMed: 207

Publications & Presentations Nine abstracts accepted to 2016 COA meeting (six podium, three poster); five abstracts accepted to 2016 ESSKA meeting (three podium, two poster); four abstracts accepted to 2016 CASEM meeting (four podium); four abstracts accepted to 2016 CORA (four poster); three abstracts accepted to 2016 COMOC (three podium); three abstracts accepted to 2016 McMaster Medical Student Research Day (one oral, two poster); and two abstracts accepted to 2016 McMaster Clinical Epidemiology and Biostatistics Research Day (two poster).

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Alumni Story MacOrtho is pleased to announce that Dr. Ilyas Aleem has recently accepted a faculty position at the University of Michigan, Ann Arbor. Dr. Aleem completed medical school at McMaster University and residency in Orthopaedic Surgery at the University of Toronto. He subsequently completed a Masterâ&#x20AC;&#x2122;s of Science in Health Research Methodology and a clinical fellowship in Spine Surgery at McMaster University.

Division of Orthopaedics PGY5 residents after an intensive day at the ninth annual CORR Trauma course in Mississauga as they prepare for their Royal College Examination.

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Division of Orthopaedic Surgery

Acheivements & Awards December 2015: Dr. Bhandari has been selected as a recipient to receive the Royal College Council Award. February 2016: Dr. Nathan Evaniew for successfully defending his PhD. His thesis was titled ‘Health Research Methodology in Spine Surgery’, and his degree will be in Health Research Methodology with a specialization in Clinical Epidemiology and Biostatistics. March 2016: Dr. Darren de SA (PGY4 Orthopaedic Surgery) was selected by the Ontario Medical Association for the Resident Achievement Award (RAA) 2016. March 2016: Dr. Colm McCarthy was recently appointed to the board of directors for the Resident Doctors of Canada (RDoC) (formerly known as CAIR). April 2016: Congratulations to Dr. Darren de SA who was selected for the 2016 Hamilton Health Sciences Medical Staff Association (MSA) Resident of the Year Award. April 2016: Congratulations to Dr. Darren de SA, who has been awarded the Hamilton Academy of Medicine Resident Award. April 2016: Congratulations to Nathan Evaniew and Kim Madden on being selected to receive a Program Award for Graduate Students at the 2016 Faculty of Health Sciences Research Plenary. June 2016: Dr. Bhandari had the honor of receiving an Award of Distinction from Attorney General Madeleine Meilleur. The Attorney General recognized individuals and organizations dedicated to helping victims of crime at the 2016 Victim Services Awards of Distinction. June 2016: Dr. Mundi successfully defended his MSc in the HRM Programme.

In the News Reuters Health interviewed Brad Petrisor about research that showed soap isn’t as good as saline for cleaning open wound fractures. CTV News, NDTV, Infection Control Today, and Voice of America reported on research led by Dr. Mohit Bhandari, which showed cleaning wounds with saline water works better than soap and water. Write-up titled “Report Suggests Knee Meniscus Surgery May Be Needless” Moin Khan, Nathan Evaniew, Asheesh Bedi, Olufemi R. Ayeni, Mohit Bhandari featured in The Globe and Mail. The Hamilton Spectator published stories about research on hip surgery, led by Drs Mohit Bhandari and Femi Ayeni. CHCH News covered the potential benefits of the same research.

Dr. Harman Chaudhry’s profile was featured in the national resident awareness week campaign on the Resident Doctors of Canada’s (RDC) official website, which represents over 9,000 resident doctors across the country. Dr. Moin Khan was interviewed by Orthopeadics this Week about femoroacetabular impingement and his recent study published in StatNature Reviews.

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Dr. Stuart Archibald, MD, FRCS(C) Division Head, Division of Otolaryngology Head and Neck Surgery

19 Publications

26 Presentations

11 Division Faculty

At a glance... The Division of Otolaryngology Head and Neck Surgeryâ&#x20AC;&#x2122;s 11 faculty comprise the surgical staff of the Division, with six based in St. Josephâ&#x20AC;&#x2122;s Healthcare, and five at Hamilton Health Sciences. Four of the faculty are subspeciality-trained head and neck surgeons, two are Fellowship-trained pediatric otolaryngologists, one is a Fellowhip-trained neurotologist, one specializes in rhinology, and the remaining three practice general otolaryngology with special interests/emphases in pediatric ENT, otology, facial plastics, or rhinology. Presently, and for the past 11 years, two residents have been accepted annually into the RTP through the CaRMS match. Of the residents who have been trained through the program, six have gone on to further Fellowship training: two in pediatric otolaryngology, three in rhinology, and one in sleep medicine. Two residents who will graduate in 2017 have been accepted in head and neck Fellowships. The remainder are in practice as general otolaryngologists with various special interests. The Division serves four hospitals in Hamilton and the faculty work in four otolaryngology head and neck teaching clinics, in addition to three private offices. The head and neck surgeons consult at the Juravinski Cancer Centre Head and Neck on a rotation basis every Friday. All offices and clinics are available for resident teaching. Close links are present with the audiologists and speech and language pathologists. Full audiological and vestibular testing is available within the geographic bounds of the SJHH ENT Clinic, and voice clinics are run at SJHH and HHS. A temporal bone laboratory situated within the Department of Anatomy at MUMC is regularly used for resident teaching.

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Otolaryngology

Education Updates

Future Direction Our future goal is to maintain our excellence in patient-centered care, to further develop our expertise in undergraduate and post-graduate education, and to grow our research output. We hope to recruit for some clinical areas not presently well represented in our program, specifically laryngology. We are planning to recruit faculty with a major commitment to translational research, and to develop linkages with other scientists in related disciplines both in McMaster and other universities. For this to occur, we are looking for additional sources of funding.

Our mission is to provide excellent service to our patients, and superb training to our residents through clinical and surgical education with research opportunities. Dr. Diane Reid is the Residency Program Director. A full range of learning venues is used in addition to the regular clinics noted above, and this includes regular multi-disciplinary thyroid and head and neck cancer conferences, clinical-pathological rounds, and radiology-clinical rounds. Journal clubs are usually run five times per year. Residents do temporal bone dissections under supervision of faculty co-ordinated by Dr. Jason Archibald. Through Adjunct Faculty in Burlington, Brantford, Cambridge, St. Catharines, Brampton, and Owen Sound, the residents can gain experience with approved community electives. Residents may compete for the Clinician Investigator Program (CIP). One of our residents completed this program, being awarded a MSc for her work. We also welcome medical students to apply to our electives program. Division members are active in undergraduate teaching as elective supervisors, tutors, and mentors. Students also take an active part in research projects.

Milestones In addition to their great reputation for teaching, the faculty are known for clinical expertise in head and neck surgery, for work in reconstructive surgery with the Division of Plastic Surgery, and in endoscopic sinus and skull base surgery in collaboration with the Division of Neurosurgery. Dr. Michael Gupta and Dr. Ted Young are members of the Thyroid Guidelines Development program of Cancer Care Ontario, and Dr. Michael Gupta and Dr. Stuart Archibald are members of the Head and Neck Disease Site Group of Cancer Care Ontario. Dr. Jonathan MacLean is active in the national development of undergraduate medical school training in otolaryngology. Dr. Diane Reid is a leader in the Competency by Design initiative of the Royal College of Physicians and Surgeons of Canada for otolaryngology.

Research The Division has a strong commitment to research under the direction of Dr. Michael Gupta, Research Coordinator. Research is usually in the areas of clinical studies, or health policy/ economics, although some basic science studies are performed. Faculty members and residents present at various meetings, and are encouraged to publish their research projects in peerreviewed journals.

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Dr. Yaron Shargall, MD, BSc, FRCS, FCCP Division Head, Division of Thoracic Surgery

The Division of Thoracic Surgery Located at St. Josephâ&#x20AC;&#x2122;s Healthcare, the division provides Hamilton and its surrounding communities with specialty care for diseases of the lung, esophagus, and mediastinum.

420

Major Lung Resections Annually

Esophageal Resections Annually

Division Faculty Members

At a glance... The Division of Thoracic Surgery continues to strive to become a highly recognized centre of excellence in Thoracic Surgery, including all three domains: clinical, educational, and academic. Over the last two years, the division has undergone major progress in order to achieve those goals. In 2016, Dr. Colin Schieman has relocated his practice to Calgary. Dr. John Agzarian, our own trainee, currently completing a fellowship at the Mayo clinic, was recruited to replace him, and will join our team in the summer of 2017.

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Division of Thoracic Surgery

Clinical Progress We continue to serve as a regional Thoracic Surgery Centre for LHIN 4, and maintained high surgical volumes with more than 420 major lung resections and more than 55 esophageal resections yearly. In a very recent Cancer Care Ontario quality indicators report, published on March 2017, our centre was recognized as the highest volumes centre in Ontario (and Canada), having the lowest readmissions rates after major surgeries in Ontario (arguably due to our innovative Integrated Comprehensive Care, aka ICC, program) and scored significantly higher than the Ontario average in all parameters. Our Robotic program continues to evolve, currently being one of only two programs in Canada to perform anatomical lung resection, performing the largest volumes of robotic lobectomies in Canada. A research led by Dr. Hanna, who also serves as the research director of the Borris Family’s Robotic Centre at St. Joseph’s Healthcare, is leading several research projects related to robotic surgery, few of which awarded grants and were published nationally and internationally. Our Advanced Thoracic Endosonography Centre (A•TEC), where we perform complex endoscopic airway and esophageal procedures, also continues to evolve, and we have expanded it further to include Endoscopic Mucosal Resections (EMR) for early esophageal malignancies as well as complex image guided navigational bronchoscopy for identification and localization of lung nodules and early lung cancer, a promising technique which will continue to evolve, keeping us in the frontline nationally and internationally. Our Esophageal Diagnostic Assessment Program (EDAP) continues to expand, looking into ways to improve early detection and diagnosis of esophageal malignances and

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decrease waiting times for assessment and treatment plan. We have developed a unique clinical pre-test probability score for patients presenting with first symptoms. This score has been validated retrospectively, presented internationally, and is now being assessed prospectively with the goal to expand its utilization for primary care providers. We have also developed, in collaboration with the SeamlessMD company, a new web/mobile application for patients to use following hospital discharge. We are currently running a prospective pilot feasibility trial to evaluate the utilization of this innovative mobile app and its impact on patients’ outcomes (postdischarge readmissions and ER visits, patients satisfaction). We are hopeful we could soon integrate this mobile app to all thoracic surgery patients. We continue to enjoy a fruitful collaborative and sustainable relationship with all major hospitals in our region and deepened our relationship with the Firestone Institute of Respiratory Health (FIRH) and the Division of Respirology at McMaster University. We continue to maintain combined multidisciplinary outreach clinics at St. Catharines General and Brantford General Hospitals, hosted together by surgeons, respirologists, and oncologists. Our Malignant Pleural Effusion and Pulmonary nodules clinics, hosted in combination with our respirology peers at the FIRH, continue to look after patients from the entire LHIN and beyond. Our ongoing unique collaboration with our peers at the University of Toronto’s Division of

Thoracic Surgery has continued to evolve, and the two divisions are currently running several clinical trials together, exchanging international trainees and collaborating on educational activities.

Education Our division has developed into a highly sought-after training site, and, over the last few years, we were able to recruit the toptier of trainees in Canada. All our graduates have successfully passed their Royal College exams and are now practicing in Canada. Our International Medical Graduates pool continues to grow and we currently have a long waiting list for clinical fellowships. Over the next few years, we will have clinical fellows from Israel, Switzerland, and Jamaica. Next year, we have been approved to expand into two Royal College residency positions, and were able to bring on two of the best candidates in Canada this year. Additionally, there are currently one Masters and five undergraduate honors students participating in various research and clinical activities with our division.

Milestones • Dr. Hanna has been appointed a member of the editorial board of The Journal of Thoracic and Cardiovascular Surgery. • Dr. Finley has been appointed as expert lead, clinical measures for Canadian Partners Against Cancer (CPAC). • Dr. Shargall was appointed as chair of the combined European Society for Thoracic Surgeons (ESTS) and the American Association for Thoracic Surgery (AATS) task force.

Research The research portfolio of our division continues to evolve. Several additional grants were obtained, including a Canadian Institute for Health Research (CIHR), McMaster Surgical Associates, Intuitive surgical research grant, and SJHH foundation. Our research team is composed of four full-time members, all funded by research grants, who are helping us sustain a very busy clinical trials agenda. We became the first surgical division at McMaster to be enrolled with the Canadian Cancer Clinical Trials Network (aka 3CTN), and our service at St. Joseph’s leads the way in multicentre surgical oncology clinical trials. We are also the first Canadian Thoracic Surgery division to join the European Society for Thoracic Surgeons (ESTS) database, the only international database for thoracic surgery worldwide. Research from our division was presented extensively nationally and internationally and several of our presentations were awarded prestigious awards by the AATS (American Association for Thoracic Surgeons), ESTS (European Society for Thoracic Surgeons), and CATS (Canadian Association for Thoracic Surgeons). In the short term, we are aiming at continuing to lead a prospective trial related to QI initiatives nationally and internationally, and it is our goal to eventually establish an evidence-based centre for Thoracic Surgery at McMaster.

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Dr. Bobby Shayegan, MD, FRCS (C) Division Head, Division of Urology

The Division of Urology The Division provides specialty urological care for Hamilton and the surrounding communities through St. Josephâ&#x20AC;&#x2122;s Healthcare Hamilton and Hamilton Health Sciences.

47 Publications

188 Presentations

14 Division Faculty

At a glance... The Division of Urology has experienced some growth and changes since the last report. Dr. Bobby Shayegan has since replaced Dr. Paul Whelan as the Division Head, Director of McMaster Institute of Urology Chair, and the David Braley and Nancy Gordon Endowed Chair in Urology. In addition, Dr. Matsumoto was appointed as Program Director for the Division of Urology Residency Program at a critical time of transition toward the Royal Collegeâ&#x20AC;&#x2122;s Competence by Design curriculum. Currently, the Division of Urology is comprised of 10 GFT, two part-time and two locum faculty members. Dr. Shahid Lambe was recruited as an academic renal transplant surgeon and the Division continues grow with the expectation of a neuro-urology GFT position at HGH along with a 0.5 FTE (within resource) urooncology addition to JH in July of 2017. We are also beginning the search process of recruitment for an academic pediatric urologist to replace Dr. DeMaria in 2018, when he is expected to retire.

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Urology Residents after writing the American Urological Exam in November 2016.

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Division of Urology

Education

Research

We continue to perform at an excellent level with respect to qualifying Royal College Examinations. Presently, all residents have passed their examinations successfully at first attempt. The Urology Residency Program currently has 15 residents, and four clinical fellows (two MIS and two renal transplantation). The Division underwent External Review and minor weaknesses were identified that are being addressed through improved evaluations and increased exposure to neuro-urology (via faculty recruitment). Curriculum development and changes associated with CBD is currently a central focus of the Division and Matsumoto’s mandate as we are expected to roll out in 2018.

The Division of Urology has had another successful year in research with excellent publication rate and impact when compared across other divisions. High rates of academic research activity continue with a number of faculty members spanning both clinical and translational domains. There is also a good amount of interdisciplinary research collaboration.

Within the education domain, the Division is now hosting the annual “CaRMS fair” in Toronto. This event organizes residency interviews at a single site in a single day across all participating universities and has increased our national exposure substantially. Moreover, we continue to attract highly ranked candidates to our training program. The Division of Urology held its fourth annual Resident Research Day on October 28, 2016. Previously, this event was combined with Western University as a combined research day. However, given the growth and development of research within the Division, we currently host an all-day resident research symposium with keynote invited visiting professors.

Milestones A selected number of recent faculty achievements in the last year are as follows: • Dr. Braga: appointed as a member of the pediatric urology editorial board of the Journal of Urology. • Dr. Kapoor: appointed as Chair of the Medical Advisory Board of Kidney Cancer Canada, and he’s also now the Chair of KCRNC (Kidney Cancer Research Network of Canada) and Chair of Guidelines Committee of the Canadian Urologic Association • Dr. Shayegan: appointed as Vice-Chair of Bladder Cancer Canada, Chair of Continuing Professional Development (CPD) at the Canadian Urologic Association and Editorial Board of BMC. • Dr. Pinthus: granted $3.5M as PI for the PC-RADICALS multicenter national trial of cardiovascular disease assessment in men with newly diagnosed prostate cancer. • Dr. Matsumoto: appointment as Program Director and Urology CBD development at McMaster University.

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Dr. David Szalay, MD, MEd FRCS (C), Division Head, Division of Vascular Surgery

The Division of Vascular Surgery The McMaster University vascular surgeons remain amongst the busiest clinicians in the country as measured by clinic visits, emergency room activity, and outpatient and inpatient procedural volumes.

3 Publications

3 Clinical Trials

6 Division Faculty

At a glance... The Division of Vascular Surgery continues to grow and evolve to meet the challenges of our expanding and aging population. The burden of peripheral vascular disease, in particular in our region, has increased disproportionately compared to most other conditions in the past decade, and it is anticipated that it will continue its dramatic growth over the next 20 years. Our group not only welcomes the challenge, but it sees it as an ideal opportunity to build on our existing nationally recognized strengths in clinical management and education, and, in addition, establish new initiatives and leadership in research and quality assurance. There has been considerable activity in the past two years to meet our current mandate and build on this strong foundation to anticipate and prepare for what lies ahead with respect to the comprehensive and optimal treatment for our patients and their families who are impacted by the many facets of peripheral vascular disease.

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Hamilton General Hospital

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Division of Vascular Surgery

Clinical Update The McMaster Vascular Surgeons remain amongst the busiest clinicians in the country as measured by clinic visits, emergency room activity, and outpatient and inpatient procedural volumes. We were instrumental in the development of the provincial vascular surgery procedural database as both a pilot site and subsequently as the largest contributor of case volumes to this valuable resource. The provincial database will play a key role in capturing activity and outcomes, resource planning, and generate large-scale collaborative academic activity and quality assurance initiatives. At a hospital level, we are active participants and leaders in NSQIP (National Surgical Quality Improvement Program) and the Ontario SQIP (Surgical Quality Improvement Project) initiative with our current focus on strategies to reduce surgical site infections in vascular surgery. Our group is the core of the first formally recognized LHIN (Local Health Integration Network) Regional Vascular Services plan in the province. We provide multisite clinic and procedural activity by our surgeons and nurse practitioner, with the principle of bringing care closer to our patients where possible and appropriate. The regional program also provides opportunity to match surgeon interest and skill set to practice setting and has been instrumental in manpower planning. The program has become very innovative and efficient in streamlining post-operative care in a very difficult fiscal environment. Our length of stay following both routine and complex surgical and endovascular interventions is amongst the lowest in the country, by a very significant margin.

The Division manages all aspects of vascular disease as a regional tertiary referral centre but is a resource for complex cases from neighbouring LHINs and many other parts of the province. In addition, we play an essential collaborative role in the co-management or support of multiple other regional programs including Cardiology and Cardiac Surgery, Trauma, the Regional Stroke Program, Surgical Oncology, Hemodialysis, and Renal Transplantation. Our contributions often go beyond providing direct clinical care as exemplified by the recent successful campaign for the Hybrid Operating Suite at the Hamilton General site. Our surgeons raised the vast majority of the capital funds through community and donor outreach, and considerable personal time and financial contributions for a resource that will be accessible to and benefit patients and families (and the hospitalsâ&#x20AC;&#x2122; other practitioners) throughout the region.

Research

â&#x20AC;¨ The past year has seen a wealth of research activity within the Division of Vascular Surgery with the procurement of grants, several publications, and presentations at various national and international meetings by both faculty members and residents. Steven Phillips has joined our group as our full-time Research Coordinator and, together with Tara Andrinopolous, who works both as our Database Coordinator and a part time Research Coordinator, have been instrumental in study design, communication with sponsors, funding

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sources and REB, and full collaboration with the surgeons and our nurse practitioner in all steps of the study process. A quarterly research newsletter has been created to highlight the research accomplishments of faculty and residents and provide updates on ongoing trials.   The division has published manuscripts in BMC Health Services Research and the Annals of Vascular Surgery, which focus on the economic burden of diabetic foot ulcers in Canada, and a case study of a patient suffering acute limb ischemia following bath salt use. Additionally, faculty members are involved in the PHRI collaborative project entitled “Technology-Enabled Remote Monitoring and Self-Management — Vision for Patient Empowerment Following Cardiac and Vascular Surgery (THE SMArTVIEW, CoVeRed),” which recently had its protocol for the randomized controlled trial published. This is a large, collaborative project between the cardiac and vascular divisions and PHRI.   Faculty members and residents for the division presented at a variety of meetings in the past year, including 10 presentations at four conferences. These conferences include the Society for Vascular Surgery in Washington, DC, the Canadian Society of Vascular Surgery in Halifax, Nova Scotia, The International Conference on Residency Education and the Canadian Association of Wound Care, both in Niagara Falls, Ontario. In addition to presenting, Dr. Michael Stacey was the conference co-chair for the Canadian Association of Wound Care annual meeting.   Approximately one year ago, a new position, the Director of Resident Research, was created in order to provide additional guidance to residents in their research

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activities. With this came new guidelines for residents to help increase research output and provide them with a diverse research portfolio after completion of the program. All residents are required to have two active research projects occurring at any time, a long-term research project which may be over the course of several years and requires long-term planning and coordination, and a short-term project which can be completed in under a year. The resident projects are supervised by faculty members, who provide guidance and direction to the residents for the duration of the projects.   The division has also been successful in obtaining external funding, with Dr. Michael Stacey receiving a CIHR bridge grant for his project examining a new intervention for healing in venous and diabetic lower limb ulcers. Dr. David Szalay, in collaboration with Bayer, is receiving funding and serves as the Canadian Lead for the conduct of the VOYAGER trial, a large, international drug trial looking at the potential role of low dose rivaroxaban to prevent postoperative cardiac and vascular events in patients undergoing lower limb vascular procedures. Several grants are currently under review for various trials from funding agencies including CIHR, the Ontario Medical Association and Ministry of Health and Long-Term Care, and several private and industry institutions.   The Division of Vascular Surgery is looking forward to the next year, with several pending grants and new projects on the horizon, as well as empowering our residents to lead a variety of research projects of their own.

Vascular Surgery Residents tested their athleticism, communication, and collaboration skills on the fields in adventurous paintball battles during the 2016 Retreat with the Program Director and Coordinator.

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Division of Vascular Surgery

Education Residency Post-Graduate Training in Vascular Surgery at McMaster University remains one of the most sought after training programs in this discipline in Canada. The program has traditionally offered a two-year fellowship stream, but, in the past five years, has participated in Royal College of Physicians and Surgeons direct entry (0-5) program. Residents and Fellows are exposed to one of the largest volumes of aortic open and endovascular cases in the country. This includes both standard and complex fenestrated, branched, and hybrid endovascular cases. Further, the program coordinates and provides financial support for all of our trainees to participate in up to three months of an international elective during their senior residency. In the past two years, our residents have been able to gain unique and invaluable experiences in Germany, France, Australia, and the United States. In addition, we have maintained our successful exchange program with Stanford University allowing a three-to-six-month exchange of senior residents/fellows from each institution to integrate into each otherâ&#x20AC;&#x2122;s program. Recently, with the support of our endowed (Beamish) chair, two of our residents have been accepted and are completing studies toward a Masters in Public Health at Harvard University. Finally, the Division of Vascular Surgery at McMaster University has developed strong ties to leading international researchers in vascular and cardiac medicine, allowing our resident trainees unlimited opportunities in clinical and bench research. Perhaps our greatest accomplishment is that, to date, all of our program graduates, in a very competitive job market, have secured staff positions in excellent community and academic hospitals across the province and country.

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Undergraduate Vascular Surgery is not a core clerkship rotation but we do attract many local and visiting medical students who seek exposure to the discipline for personal interest and education, and, in many cases, in considering a potential career choice. These electives are well received by both students and staff and are reflected in evaluations and recommendations. Our faculty members are active as lecturers at large group sessions, student advisors to medical undergraduates, and as mentors and supervisors to summer students and senior level students in the Health Sciences Program at McMaster completing thesis projects and courses. Continuing Medical Education Our faculty members remain very active in participating in and organizing continuing education events at a local, provincial, and national level. These events include numerous invited local presentations to primary care and specialty physician groups, as well as presentation, planning, and organization responsibilities at annual review courses such as the Winnipeg Vascular and Endovascular Symposium, The National Capital Vascular Symposium and the Tremblant Vascular Symposium. Our surgeons have participated in the development of national consensus guidelines for the management of thoracic aortic disease and remain active in the provision and editing of patient and physician education websites. Finally, they are active reviewers for highly regarded peer reviewed journals.

Division of Vascular Surgery

Alumni Story

(1998-1999) and many national level board appointments including the Canadian Medical Association, Health Canada Task Force, and the Royal College of Physicians and Surgeons of Canada. After leaving McMaster, Dr. Mastracci went on to complete an Aortic Endovascular Fellowship at the Cleveland Clinic and then remained on faculty there and at Case Western Reserve University from 2008 to 2014, where she worked with pioneers and world leaders in complex endovascular aortic interventions. In 2014, she was recruited to London, England, where she is the Aortic Lead, Complex Aortic Surgery and Consultant Vascular Surgeon with the Royal Free London NHS Foundation Trust.

Dr. Tara M. Mastracci Dr. Tara Mastracci (McMaster Vascular Surgery, 2007) has established a very accomplished and rewarding career in a remarkably short time after completing her fellowship training in our program. Tara is originally from the Niagara region and completed her undergraduate degree and medical school here at McMaster. She remained at McMaster for her residency in General Surgery (graduating in 2005) and subsequently completed both her Masters in Health Research Methodology and Vascular Surgery training in the following two years. Her clinical, leadership and academic potential was readily evident during her time at McMaster with multiple publications, awards, and executive responsibilities including President of the Canadian Federation of Medical Students

Dr. Mastracci is now an internationally recognized authority in advanced aortic endovascular interventions with focused research interests in radiation safety, advanced imaging and processing techniques, understanding learning curves, and optimizing clinical outcomes in complex aortic repairs. She has authored or co-authored more than 100 peer reviewed journal articles, multiple book chapters, and consensus treatment guidelines. She has presented her work at academic meetings, and at review courses or as an invited speaker all over the world, and has been profiled in one of Britainâ&#x20AC;&#x2122;s leading national newspapers. All of this in her first decade of practice! The Division of Vascular Surgery at McMaster Surgery is extremely proud of all that Tara has achieved in the early years of her professional journey. We wish her the best for ongoing and enduring success and are confident that there are many more accolades ahead!

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Division of Vascular Surgery

Milestones

Dr. John Harlock: Appointed as Academic Program Director for the Vascular Surgery Post-Graduate Education program. Successfully gained full academic approval with the Royal College at the 2016 External Review. Academic: Secondary panel writing member for the published guidelines for Canadian Cardiovascular Society Guidelines on Peroperative Cardiac Risk Assessment and Management for Patients who undergo noncardiac surgery. Named as Local PI for the Industry sponsored Cook Alpha Graft registry trial and Local PI for the EVAR Pilot Study looking Major cardiovascular complications in patiens undergoing EVAR repair – a multicenter prospective cohort study. Reapproved as Local PI for ongoing joint HHS Vascular Surgery and Thrombosis and Atherosclerosis Research Institute (TaARI) tissue bank for atherosclerotic and aneurysm human tissue. Administrative: Appointed member of the Canadian Society for Vascular Surgery Executive Committee as Program Director for the Annual Meeting. Appointed Member of the Royal College Specialty Committee on Vascular Surgery. Dr. Vikram Iyer: Promoted To Associate Professor, Department Of Surgery in 2016. Chosen as site Principal Investigator for The Rangers II trial - - an international multicenter randomized trial evaluating drug-coated balloons in the lower extremity. Awarded Diploma In Advanced Endovascular Aortic Intervention from University of Lille, France in 2017.

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Dr. Theodore Rapanos: Promoted to Associate Professor, Department of Surgery in 2016. Named Section Chair in Vascular Surgery with the Ontario Medical Association. Appointed as the Research Director of the vascular residency program, and will be the Primary Investigator on an upcoming clinic trial on intra-operative imaging with General Electric. Dr. Rapanos is also currently coordinating the creation of the National Conference for Venous Care, which will provide a forum for discussion around current standards and research being conducted within the field for Vascular Surgeons, Residents and researchers from across the country. Dr. Michael Stacey: Surgeon-in-Chief at Hamilton Health Sciences and member of Executive Leadership Team. Named as Chair of Research Committee for Wounds Canada. Appointed as Member of Health Quality Ontario: Wound Care Quality Standards Advisory Committee. Dr. Stacey has two provisional patent applications, the first being “Online self-management for outpatient peripheral arterial disease patients” (with Dr. Norm Archer from Business School, McMaster University), and a second “ Biomarkers of wound healing.” He is the supervisor for two graduate school students, Janine Duquette (Doctor of Nursing, Walden University, USA) and Simona Gabrielle (Masters student, McMaster University).

Dr. David Szalay: Named National Lead Investigator and International Steering Committee Member for Voyager PAD Trial. Reappointed as member (nucleus committee) of Royal College Specialty Committee in Vascular Surgery. Surgeon Champion, (Hamilton General site) for NSQIP (National Surgical Quality Improvement Program).Reappointed Clinical Lead Vascular Surgery for LHIN 4 and member of the Provincial Vascular Care Working Group Dr. Jacques Tittley: Reappointed for third term as Beamish Family Foundation Chair in Vascular Surgery. Chair: Hybrid Operating Suite Community Fundraising Campaign (which has raised more than $2 million from community donors toward a total of $5 million. Continues as Co-chair of Tremblant Vascular Symposium. Ongoing clinical leadership and investigation related to open and endovascular aortic arch reconstruction.

Dr. John Harlock was appointed as Academic Program Director for the Vascular Surgery PostGraduate Education program.

Dr. Michael Stacey was named Chair of the Research Committee for Wounds Canada last year.

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Resident Research Day Winners 2015-2016 General Surgery 2015 1st Place - Dr Tabitha Tse (PGY-4) The Attachment and Personality Profiles of Surgical vs. Medical Patients with Crohnâ&#x20AC;&#x2122;s Disease: A Pilot Feasibility Study 2nd Place - Dr Elena Parvez (PGY-5) Evaluation of a Structured Hernia Repair Course for Intern Physicians in Northern Uganda 3rd Place - Dr Shiraz Elkheir (PGY-5) Simethicone in Postoperative Ileus Trial (SPOT), RCT

2016 1st Place - Siddharth Nath (MD/PhD Candidate) Atraumatic versus traumatic lumbar puncture needles: A systematic review and meta-analysis 2nd Place - Merrick Fallah (Pediatric Neurology Research Assistant) The use of scalp EEG to identify focal cortical dysplasia in children 3rd Place- Victor Lam Shin Cheung (MD Student) National survey of Canadian spine surgeons: Postoperative care and restrictions following lumbar surgery

Neurosurgery

Plastic Surgery

2015 1st Place - Dr. Jerry Chen (Adult Neurology PGY4) Warfarin-related intracerebral hemorrhage: Predictors of hematoma expansion and in-hospital mortality

2015 Best Clinical Epidemiology Presentation Dr. Maleka Ramji (PGY-3) Efficient imaging â&#x20AC;&#x201D; Examining the value of ultrasound in the diagnosis of traumatic adult brachial plexus injuries: A systematic review

2nd Place - Dr. Surabi Nadarajah (Adult Neurology PGY5) Taking a stride in acute stroke management: Performance outcomes of a community hospital implementing thrombolysis via ED Telestroke model

Best Clinical Presentation Dr. Chris Coroneos (PGY-4) Reduced venous complications and operative time with anastomotic coupling device (ACD) versus hand-sewn anastomoses: A cohort study

3rd Place - Dr. Kaitlyn Siu (Pediatric Neurology PGY4) Feasibility and reliability of muscle strength testing in critically ill children

Education/Basic Science Dr. Sophocles Voineskos (PGY 5) Plastic evidence: A plastic surgery evidence database

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2016 Best Clinical Presentation Dr. Christopher Coroneos Attitudes, Practice Patterns, and Barriers for Breast Cancer Reconstruction: A provincial survey Best Epidemiology Presentation Dr. Alexandra Hatchell Gynecomastia classification for surgical management: A systematic review

Ophthalmology Winners of the Dr. Jeffrey Sher Research Award: 2015 Dr. Vasudha Gupta (PGY5) LASIK Flap Striae Requiring Flap Re-Lift and Irrigation 2016 Dr. Manreet Alangh (PGY5) CJO RESCUE

Harman Chaudhry (SSP/CIP): The Hip Fracture Model of Care: Time for an Evolution? Thomas Wood (PGY4): Preoperative Predictors of Pain Catastrophizing, Anxiety and Depression in Patients Undergoing Total Joint Replacement

Otolaryngology 2015 - 2016 1st Place - Dr. David Choi (PGY3) Aloe Vera Versus Control for the Treatment of Oral Lichen Planus and Burning Mouth Syndrome: A Systematic Review 2nd Place - Dr. Natasha Cohen (PGY4) Developing a New Diagnostic Algorithm for Human Papilloma Virus Associated Oropharyngeal Carcinoma: An Investigation of Novel Surrogate Testing

Urology 2015 1st Place - Dr Yuding Wang (PGY 3)

Orthopedic Surgery

2nd Place - Dr Shawn Dason (PGY 4)

Best of Resident Research: 2015-16

3rd Place - Rahul Bansal (PGY 4)

Nathan Evaniew (SSP/CIP): The Scholarly Influence of Orthopaedic Research: Conventional and Alternative

2016 1st Place - Derek Bos 2nd Place - Yanbo Guo

Raman Mundi (SSP/CIP): Exploring Outcomes in Orthopaedic Trauma

3rd Place - Taehyoung Lee

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Dr. Robert Hansebout, MD, MSc ,CSPQ, FRCSC, FAANS, FACS Professor Emeritus, Department of Surgery Chair 1989 - 1999

Alumni Message It is of interest to reflect on events occurring in the Hamilton and University surgical environment during the last two years. Most of the surgical retirees I have spoken to lately seem mentally intact and all are busy. I have often heard the expression "I don't know how I had time to do surgery in the past, as there is so much to do every day." However, at our age, medical problems are commonplace. One disturbing facet of elderly lives is the enormous expenditure of time needed when one attends an emergency room or tries to see a colleague for a medical problem. Medical rationing in Canada seems to be getting worse, with physician income dropping and surgeon operating times decreasing as hospitals close operating rooms to balance the budget. One canâ&#x20AC;&#x2122;t help but wonder what is going to be done in the future to assure more timely care in Canada? Perhaps the time is nearing when a private system needs to be developed to accompany our "universal healthcare system," as exists in several countries such as Australia, Britain, and others. Patients in Canada have some of the longest wait times for surgical procedures amongst developed nations. As governments and insurance companies exert more control, wait times in emergency rooms in the United States are also increasing, but surgical wait times are very short by comparison with Canada. With regret, I wish to remember some of the alumni who could not attend, who we lost during the last two years. We were sorry to see them go and wish to express our condolences to their families. Dr. Richard Farmer, Plastic Surgeon, died October 6, 2016 at the age of 89. Dr. Richard Butson, General Surgeon, died March 24, 2015 in his 93rd year.

Dr. Robert Hadden, Otolaryngologist, died July 26, 2014 in his 88th year. Dr. Richard Lachowski, Orthopedic Surgeon, died November 27, 2014 at the age of 60. Dr. William Love Sr., Otolaryngologist, died October 17, 2014 at the age of 93. Dr. John Madronich, a classmate of mine who served the Hamilton community as an Ophthalmologist for many years, died April 23, 2015 at the age of 82. Dr. C. Barber Mueller, General Surgeon and Founding Chair of the McMaster University Department of Surgery died February 13, 2014 at the age of 97. Dr. John Ashworth, an Anesthesiology colleague, died on September 16, 2016 at the age of 88. I continue to marvel at accomplishments of some of the younger surgeons in the department that I know well. Dr. Mehran Anvari has not only helped develop robotic surgery, but is facilitating shortening of wait times for surgery in hospitals by training other surgeons in minimal invasive surgery techniques. His continued collaboration with NASA may extend surgical care during space travel. Dr. Ved Tandan has finished his tenure as president of the OMA. He has helped strengthen the voices of physicians in the hospital environment. Dr. Mark Walton has done much as Assistant Dean, Postgraduate Medical Education in facilitating surgical postgraduate training and will be stepping down soon. Dr. Peter Fitzgerald, as President of the McMaster Children's Hospital has continued to oversee the development of adequate care for our children and grandchildren. Dr. Mohit Bhandari has achieved international recognition for Orthopedic Surgery at

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McMaster University in view of his research and statistical prowess as well as personal recognition. Dr. William Orovan, during his time as Chair of Surgery, was able to integrate an alternative funding plan for surgery, attracting many former part-time University surgeons into the department and successfully addressing the "town and gown" problems. He continues at McMaster as Associate Dean of Clinical Services. Dr. Susan Reid has continued to expand the size of the department while admirably coping with the increasing administrative, teaching, research, and surgical events within the department. At the Annual General Meeting of the Hamilton Academy of Medicine at the Royal Botanical Gardens on June 17, 2015, Dr. Steve Szarka was installed as the 116th president of the Hamilton Academy of Medicine. Mrs. Agnes Hansebout received the Kim Harper Service Award for her longstanding voluntary contributions to the community. Dr. William Finn received a 50-Year Membership Award. At the Annual General Meeting of the Hamilton Academy of Medicine at LIUNA Banquet Facilities on June 17, 2016, Dr. Jennifer Brasch was welcomed as the 117th president of the Hamilton Academy of Medicine. A Community Services Award was presented to Mr. Rob MacIsaac, President and CEO of the Hamilton Health Sciences, for his contributions to the community. Ms. Teresa Cascioli, received the Kim Harper Service Award for her voluntary contributions to the community. Dr. Caroline Levis, Head of Plastic Surgery at St. Joseph's Hospital, received the Distinguished Service Award in 2016. Dr. David Wismer, Orthopedic Surgeon, received the OMA Life Membership Award. Dr. Darren De SA, Orthopedic resident was awarded the OMA Resident Achievement Award.

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Retired surgeons can remain active and meet their friends at a variety of functions open to them. There are Annual Staff Dinners at both St. Joseph's Hospital and the Hamilton Health Sciences which are free for retired staff members. The Department of Surgery also hosts an Annual Resident Appreciation Dinner and event in the spring. At this venue, which spouses may also attend, one can not only reunite with colleagues from past and present, but also meet the new residents in various divisions. The Hamilton Academy of Medicine and the Hamilton Medical-legal Society usually have Christmas cocktails or dinners, which are open to members. Dr. Daniel Kraftcheck, in collaboration with the Hamilton Academy of Medicine, has organized a series of lunches in various fine restaurants across the region. This is referred to as the Retired Old Doctors Eating Out (RODEO) and is usually attended by between 25 and 50 physicians, in family medicine and all medical and surgical specialties. It is open to all retired physicians, both male and female. Meetings are in a relaxed atmosphere with conversation at a prelunch cocktail and afterward at the various tables. There are no invited speakers. Attendance appears to be increasing. For further details, call Grace or Maryann at the Hamilton Academy of Medicine. There is also another group of retirees, attended by businessmen and a few surgeons and anesthesiologists: the Gentlemen Who Lunch (GWL). Organized by Dr. Ian Dale, the group meets at Dr. Dale's home on the first Wednesday of each month, have a scotch, and then enjoy lunch at the Westminster Arms facility in Dundas. Further details are available through Dr. Dale.

I suggest that retired surgeons attend the specialty Annual Resident Research Day held at various times of the year. At these meetings, there is often a guest lecturer but the meeting is taken up mostly by resident presentations on various surgical subjects. There is usually a midday luncheon followed by afternoon presentations and the selection of the best presenter at the end of the day. Your presence will no doubt be much appreciated, especially by the residents who may have heard about you, but who have not met you. I also encourage surgeons to attend Surgical Rounds given by various specialties throughout the year, except for summer, in designated hospitals. Older surgeons are encouraged to participate in the discussion of cases, in view of their considerable experience, often greater than most of the other attendees. It is also wise to keep up with the latest developments in one's field, especially for maintenance of competence if you wish to keep your license. Surgeons are welcomed as teachers, especially in the McMaster problem-based small group sessions, and in the teaching of anatomy and other courses. As opposed to the past, there are often standardized fees for teaching sessions.

have substantial information about that interval of time. I have interviewed a number of the older surgeons about the early days but need more interaction in a few divisions. I will also need help from surgeons familiar with surgical events from 2000 until the present. Since history requires reasonably accurate dates, the process is slow, but I trust I will be ready to publish it in another year or two. I may be knocking at your door for information. It has been exciting for me during my retirement to continue to be involved in certain facets of the academic Department of Surgery and I will continue to strive to represent the alumni.

Dr. Robert Hansebout, MD, MSc, CSPQ, FRCSC, FAANS, FACS

In 2011, Dr. Susan Reid asked if I would consider writing short historical articles on the various surgical divisions as reflected through the eyes of a senior colleague. Since that time, I have written approximately 20 such articles, which have been published in the bi-annual Department of Surgery Newsletter. I am in the process of writing a book containing historical aspects of the Department of Surgery at McMaster University, encouraged by Dr. Susan Reid. It is slow going, trying to dig up facts from the beginning of the Department of Surgery at McMaster University to the time I came here from McGill in 1979. I have personally experienced the 1979 through 1999 eras and

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Faculty Professor & Academic Chair Reid, Susan: General Surgery

Avram, Victoria: Orthopaedic Surgery Ayeni, Femi: Orthopedic Surgery Bailey, Karen: Pediatric Surgery Associate Professor & Braga, Luis: Pediatric Urology Associate Chair, Education Burrow, Sarah: Pediatric Orthopedics Kelly, Stephen: General Surgery Cadeddu, Margherita: General Surgery Cenic, Aleksa: Neurosurgery Professor & Associate Chair, Research Chaudhary, Varun: Ophthalmology Bhandari, Mohit: Orthopedic Surgery Choi, Matthew: Plastic Surgery Chu, Victor: Cardiac Surgery Professor Emeritus Cybulsky, Irene: Cardiac Surgery Cameron, Gordon: Pediatric Surgery Davies, Timothy: Urology Hansebout, Robert: Neurosurgery Deheshi, Benjamin: Orthopedic Surgery Harvey, John: Ophthalmology Denkers, Matthew: Orthopedic Surgery Martin, Robert: Orthopedic Surgery Dyub, Adel: Cardiac Surgery Whelan, Paul: Urology Faidi, Samir: General Surgery Finley, Christian: Thoracic Surgery Geographic Forbes, Shawn: General Surgery Full-Time Professor Ghert, Michelle: Orthopedic Surgery Anvari, Mehran: General Surgery Gmora, Scott: General Surgery Bain, James: Plastic Surgery Gunnarsson, Thorsteinn: Neurosurgery Cameron, Brian: Pediatric Surgery Gupta, Michael: Otolaryngology Head & Neck Dath, Deepak: General Surgery Harvey, Patricia: Ophthalmology DeMaria, Jorge: Urology Hodgson, Nicole: General Surgery Fitzgerald, Peter: Pediatric Surgery Hong, Dennis: General Surgery Flageole, Helene: Pediatric Surgery Isaza, Gloria: Ophthalmology Kapoor, Anil: Urology Iyer, Vikram: Vascular Surgery Lamy, Andre: Cardiac Surgery Kachur, Edward: Neurosurgery Marcaccio, Michael: General Surgery Kahnamoui, Kamyar: General Surgery Miller, John: Thoracic Surgery Klurfan, Paula: Neurosurgery Orovan, William: Urology Korman, Bruce: Otolaryngology Head & Neck Stacey, Michael: Vascular Surgery Lee, John: Cardiac Surgery Walton, Mark: Pediatric Surgery Levis, Carolyn: Plastic Surgery Lovrics, Peter: General Surgery Associate Professor MacLean, Jonathan: Otolaryngology Head & Neck Adili, Anthony: Orthopedic Surgery Matsumoto, Edward: Urology Amin, Nalin: General Surgery Peterson, Devin: Pediatric Orthopedics Archibald, Jason: Otolaryngology Head & Neck Petrisor, Brad: Orthopaedic Surgery Archibald, Stuart: Otolaryngology Head & Neck Piercey, Kevin: Urology Avram, Ronen: Plastic Surgery Pinthus, Jehonathan: Urology

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Rapanos, Ted: Vascular Surgery Rodriguez, Amadeo: Ophthalmology Ruo, Leyo: General Surgery Sabri, Kourosh: Ophthalmology Semelhago, Lloyd: Cardiac Surgery Shargall, Yaron: Thoracic Surgery Shayegan, Bobby: Urology Simunovic, Marko: General Surgery Singh, Sheila: Neurosurgery Sne, Niv: General Surgery Sogbesan, Enitan: Ophthalmology Strumas, Nick: Plastic Surgery Szalay, David: Vascular Surgery Tandan, Ved: General Surgery Tittley, Jacques: Vascular Surgery Whitlock, Richard: Cardiac Surgery Williams, Dale: Orthopaedic Surgery Assistant Professor Ajani, Olufemi: Pediatric Neurosurgery Algird, Almunder: Neurosurgery Bouvier, Stephanie: Otolaryngology Head & Neck Cooper, Jim: Plastic Surgery Duivenvoorden, Helga: Research Engels, Paul: General Surgery Eskicioglu, Cagla: General Surgery Hanna, Wael: Thoracic Surgery Harlock, John: Vascular Surgery Khanna, Vikas: Orthopedic Surgery Lambe, Shahid: Urology McRae, Mark: Plastic Surgery McRae, Matthew: Plastic Surgery Nenshi, Rahima: General Surgery Parry, Domenic: Cardiac Surgery Rice, Tim: General Surgery Ristevski, Bill: Orthopedic Surgery Serrano, Pablo: General Surgery Sogbesan, Enitan: Ophthalmology Yang, Ilun: General Surgery Yarascavitch, Blake: Pediatric Neurosurgery

Part-time Clinical Professor Bednar, Drew: Orthopedic Surgery Keshavjee, Shafique: General, Cardiac, and Thoracic Surgery Mah, Jung: Orthopedic Surgery Reddy, Kesava: Neurosurgery Sommer, Doron: Otolaryngology Head & Neck Thoma, Achilles: Plastic Surgery Young, JEM: General Surgery, Otolaryngology, and Thoracic Surgery Associate Clinical Professor Ahuja, Nina: Ophthalmology Baillie, Frank: General Surgery Csordas, James: Ophthalmology Dal Cin, Arianna: Plastic Surgery de Beer, Justin: Orthopedic Surgery Drew, Brian: Orthopedic Surgery Dunlop, Brett: Orthopedic Surgery Foster, Stephen: General Surgery Gagic, Nenad: General Surgery Gregor, Paul: General Surgery Harnett, Barry: Oral & Maxillofacial Surgery Hollenberg, Robert: Pediatric Neurosurgery Josefchak, Robert: Orthopedic Surgery Kessaram, Robert: General Surgery Murty, Naresh: Neurosurgery Ogilvie, Rick: Orthopedic Surgery Philippon, Marc: Orthopedic Surgery Prodger, Dwight: General Surgery Ram Mohan, Surianarayanan: General Surgery and Vascular Surgery Reid, Diane: Otolaryngology Head & Neck Sanders, Ken: General Surgery Slobogean, Gerard: Orthopedic Surgery Smith, Frank: Orthopedic Surgery Sproat, Janet: Plastic Surgery Stephen, Wesley: General Surgery Wells, John: Neurosurgery

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Faculty Winemaker, Mitchell: Orthopedic Surgery Wismer, David: Orthopedic Surgery Zalzal, Paul: Orthopedic Surgery Zikman, Jerrold: Urology Ophthalmology Assistant Clinical Professor Baeta, Basil: General Surgery Baker, Darrel: General Surgery Ballagh, Robert: Otolaryngology Head & Neck Beattie, Anne: Ophthalmology Beiko, George: Ophthalmology Bharadwaj, Vinod: Otolaryngology Head & Neck Bindlish, Vinita: Ophthalmology Bindlish, Rajiv: Ophthalmology Blewett, Christopher: General Surgery Bowser, Daniel: General Surgery Brien, Heather: General Surgery Caetano, Helen: Otolaryngology Head & Neck Carleson, Lloyd: Plastic Surgery Cranford, Jeffrey: General Surgery Dale, Norman: Orthopaedic Surgery Davis, Ian: Urology Devilliers, Rocco: Neurosurgery Dore, Edward: Oral & Maxillofacial Surgery Dunin-Bell: General Surgery Durant, Craig: Vascular Surgery Eino, Dalia: Ophthalmology Fava, Mark: Ophthalmology Fischer, Marc: Anthony Urology Gafoor, Mohamed: General, Cardiovascular, and Thoracic Surgery Gehman, Kenneth: General and Thoracic Surgery Greenspan, Michael: Urology Guirguis, Emad: General Surgery Harpur, George: General Surgery Harris, William: General Surgery Hasanee, Khalid: Ophthalmology Heddle, Stewart: Plastic Surgery Heller, Barbara: General Surgery Heritz, Dianne: Urology

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Hillson, Tim: Ophthalmology Holler, Theresa: Otolaryngology Head & Neck Huq, Nasimul: Plastic Surgery Husien, Mohammed: General Surgery Hynes, Nicolas: Plastic Surgery Jackson, Bernard: Otolaryngology Head & Neck Jansz, Godfrey: Urology Jeney, Elizabeth: Otolaryngology Head & Neck Khan, Yasser: Ophthalmology Kobetz, Lawrence: Ophthalmology Kobylecky, Anna: General Surgery Korkis, Joseph: Otolaryngology Head & Neck Lamont, Robert: General Surgery Lemckert, Ronald: Otolaryngology Head & Neck Lisi, Michael: General Surgery Macmillan, James: General Surgery Mann, Keith: Ophthalmology Mapeso, Gabriel: General Surgery Martin, David: Orthopedic Surgery Martin, James: Ophthalmology Martin, Stuart: Plastic Surgery Menkarios, Gamal: Otolaryngology Head & Neck Missiuna, Paul: Orthopedic Surgery Moro, Jaydeep: Orthopedic Surgery Nandagopal, Narayanan: Plastic Surgery Nasser, Hamid: General and Thoracic Surgery Nijhawan, Navdeep: Ophthalmology Patterson, Robert: Plastic Surgery Petrelli, Tina: Nurse Practitioner, Pediatric Neurosurgery Phillips, Stephanie: General Surgery Porte, Arthur: Orthopedic Surgery Pugh, David: Orthopedic Surgery Punthakee, Dinshaw: Orthopedic Surgery Rajaratnam, Krishan: Orthopedic Surgery Reed, John: General Surgery Richie, Steven: Orthopedic Surgery Rifkind, Aaron: Ophthalmology Robert, Paul: Orthopedic Surgery Robichaud, Jeff: Otolaryngology Head & Neck

Rogers, James: General Surgery Sacevich, Nathan: Orthopedic Surgery Sadler, John: Orthopedic Surgery Saunders, Louis: Orthopedic Surgery Sawula, Donald: General Surgery Shortt, Rodger: Plastic Surgery Song, Tom: Urology Sowery, Richard: Urology Telang, Harshad: General Surgery Wiesenthal, Alain: Otolaryngology Head & Neck Williard, Peter: General Surgery Zalzal, Paul: Orthopedic Surgery

Chiasson, Paul: Thoracic Surgery Correia, Jason: General Surgery de Kleer, Nancy: Plastic Surgery Downie, David: General Surgery Doyle, Jeffrey: General Surgery Elias, Rami: Urology Geddes, Christopher: Orthopedic Surgery Geddes, Scott: General Surgery Gharsaa, Osama: Orthopedic Surgery Gowing, Robert: General Surgery and Vascular Surgery Grace, Douglas: Plastic Surgery Green, Lawrence: General Surgery Adjunct Grosso, Paul: Orthopedic Surgery Abdel-Malik, Rafik Ramzy: General Surgery Haddad, Dimitri: Orthopedic Surgery Adam, Robert: Ophthalmology Hamour, Faisal: General Surgery Afolabi, Oluwatola: Plastic Surgery Hanrahan, Renee: General Surgery Akkor, Sueda: Ophthalmology Hassard, Frank: Ophthalmology Alangh, Manreet: Ophthalmology Hupel, Thomas: Orthopedic Surgery Al-Harbi, Khalid: General Surgery Irshad, Kashif: General and Thoracic Surgery Alexander, Pradeep: Orthopedic Surgery Jansz, Godfrey: Urology Allard, Christopher: Urology Jayaram, Srinidhi: Vascular Surgery Arshinoff, Steve: Ophthalmology Kalchman, Marc: Orthopedic Surgery Ashe, Kassem: Cardiac Surgery Khan, Iqbal: General Surgery Aziz, Dalal: General Surgery Khetani, Justin: Otolaryngology Head & Neck Banerjee, Avik: Otolaryngology Head & Neck Klinghoffer, Zachary: Urology Banglawala, Sarfaraz: Otolaryngology Head & Neck Kolbasnik, Jeff: General Surgeon Bharadwaj, Vinod: Otolaryngology Head & Neck Kolyn, Donna: General Surgery Bhojani, Faizal: General Surgery Kwan, Kevin: Urology Bindlish, Vinita: Otolaryngology Head & Neck Kwapis, Jessica: General Surgery Bischoff, Markus: Orthopedic Surgery Kwok, Desmond: Orthopedic Surgery Brown, Ian: Urology Lau, Rick: Orthopedic Surgery Brown, Stephen: Plastic Surgery Le Roux, Bartholomeus: Orthopedic Surgery Bui, Luke: General Surgery Liaconis, Harry: General Surgery Calotti, Faidi: Ophthalmology Love, William: Urology Chahal, Vickramjit: Plastic Surgery Lu, Christopher: Orthopedic Surgery Chan, Edward: General Surgery Lysecki, Paul: General Surgery Chan, Toby: Ophthalmology Macleod, Heather: General Surgery Chang, Michelle: Urology Makar, Hossam: General Surgery Chaterjee, Suman: Urology Makar, Magdy: General Surgery

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Faculty Manjoo, Ajay: Orthopedic Surgery Martin, Glynn: Orthopedic Surgery Masnyk, Robert: Orthopedic Surgery Mathew, Paul: Orthopedic Surgery Maurice, Michael: General Surgery McAlister, Chryssa: Ophthalmology McCall, John: Orthopedic Surgery McKenzie, Scott: Orthopedic Surgery Minet, Wyatt: Otolaryngology Head & Neck Moammer, Gemah: Orthopedic Surgery Morris, Thomas: Urology Nayan, Smriti: Otolaryngology Head & Neck Oâ&#x20AC;&#x2122;Sullivan, John: Orthopedic Surgery Ostrowski, John: Orthopedic Surgery Paun, Bogdan: General Surgery Pawliwec, Walter: General Surgery Poenaru, Dan: General and Pediatric Surgery Qutob, Majdi Shaker: Orthopedic Surgery Rabinovich, Alexander: Orthopedic Surgery Ramakrishna, Jayant: Otolaryngology Head & Neck Rittenhouse, Bryan: Orthopedic Surgery Robert, Christopher: Orthopedic Surgery Roth, Kirk: Urology Roth-Albin, Karina: General Surgery Sayal, Manoj: General Surgery Scriven, Ted: Orthopedic Surgery Sharda, Rajeshvar: Ophthalmology Sharkey, Paul: General Surgery Sheikh, Ad Adeel Ali: Urology Sheikh, Amber: Ophthalmology Shenker, Robert: Plastic Surgery Sing, Roland: Urology Singh, Ravinder: General Surgery Snider, Matthew: Orthopedic Surgery Song, John: Orthopedic Surgery Stevens, David: Orthopedic Surgery Stevenson, Peter: Orthopedic Surgery Teoh, Kevin: General, Cardiovascular, and Thoracic Surgery

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Venkateswaran, Vikram: Orthopedic Surgery Vigna, Lorenzo: Otolaryngology Head & Neck Violette, Philippe: Urology Voice, Sandra: Plastic Surgery Wickens, Brandon: Otolaryngology Head & Neck Wilkinson, John: Ophthalmology Woolfrey, Michael: Orthopedic Surgery Yepes Restrepo, Natasha: Ophthalmology Young, Peter: Plastic Surgery Professor (Part-Time) Farrokhyar, Forough: Director Surgical Research Services Assistant Professor (Part-Time) Sprague, Sheila: Orthopedic Surgery Associate Professor (Part-time) Sonnadara, Ranil: Research, Skills Acquisition & Medical Education

New Faculty starting July 1, 2017 Assistant Professors (Full-time) Agzarian, John: Thoracic Surgery Sharma, Sunjay: Neurosurgery VanHouwelingen, Lisa: Pediatric General Surgery

New Professors in 2017 Associate Professors being promoted to Professor next year Ghert, Michelle: Orthopedic Surgery Lovrics, Peter: General Surgery Shargall, Yaron: Thoracic Surgery Simunovic, Marko: General Surgery

Faculty in action! Clockwise: Dr. Achilleas Thoma, Dr. Sheila Singh, Dr. Mohit Bhandari, Dr. Karen Bailey, Dr. Jehonathan Pinthus, and Dr. Anil Kapoor.

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Publications (July 2014-June 2015) Cardiac Surgery Belley-Côté EP, Whitlock RP, French B, Evaniew N, Kimmel SE. Effects on bleeding complications of pharmacogenetic testing for initial dosing of vitamin K antagonists: a systematic review and meta-analysis: comment. J Thromb Haemost. 2015 Jun;13(6):1162-4. Belley-Côté EP, Whitlock RP, French B, Evaniew N, Kimmel SE. Clinical benefits of pharmacogenetic algorithm-based warfarin dosing: Meta-analysis of randomized controlled trials: Comment. Thromb Res. 2015 Jul;136(1):180-1. Bucholz EM, Whitlock RP, Zappitelli M, Devarajan P, Eikelboom J, Garg AX, Philbrook HT, Devereaux PJ, Krawczeski CD, Kavsak P, Shortt C, Parikh CR; for the TRIBEAKI Consortium. Cardiac Biomarkers and Acute Kidney Injury After Cardiac Surgery. Pediatrics. 2015 Apr;135(4):e945-56. Garg AX, Kurz A, Sessler DI, Cuerden M, Robinson A, Mrkobrada M, Parikh CR,Mizera R, Jones PM, Tiboni M, Font A, Cegarra V, Gomez MF, Meyhoff CS, VanHelder T, Chan MT, Torres D, Parlow J, Clanchet MD, Amir M, Bidgoli SJ, Pasin L,Martinsen K, Malaga G, Myles P, Acedillo R, Roshanov PS, Walsh M, Dresser G,Kumar P, Fleischmann E, Villar JC, Painter T, Biccard B, Bergese S, Srinathan S, Cata JP, Chan V, Mehra B, Wijeysundera DN, Leslie K, Forget P, Whitlock R, Yusuf S, Devereaux PJ; for the POISE-2 Investigators. Perioperative Aspirin and Clonidine and Risk of Acute Kidney Injury: A Randomized Clinical Trial. JAMA. 2014 Dec 3;312(21):2254-64. Ghadimi K, Vernick WJ, Horak J, Gutsche JT, Hanif H, Tagarakis GI, Whitlock RP, Augoustides JG. CASE-12-2014 Inferior vena cava compression by retroperitoneal

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hematoma during cardiopulmonary bypass. J Cardiothorac Vasc Anesth. 2014 Oct;28(5):1403-9. Guida P, Mastro F, Scrascia G, Whitlock R, Paparella D. Performance of the European System for Cardiac Operative Risk Evaluation II: A meta-analysis of 22 studies involving 145, 592 cardiac surgery procedures. J Thorac Cardiovasc Surg 2014 Dec;148(6):3049-3057. Habbab L, Alfaraidi H, Lamy A. Surviving catastrophic disintegration of a large left atrial myxoma: The importance of multidisciplinary team. J Surg Case Rep. 2014 Sep 12;2014(9). Hébert PC, Fergusson DA, Hutton B, Mazer CD, Fremes S, Blajchman M, MacAdams C, Wells G, Robblee J, Bussières J, Teoh K; for the BART Investigators. Regulatory decisions pertaining to aprotinin may be putting patients at risk. CMAJ. 2014 Dec 9;186(18):1379-1386. Hopkins RB, Burke N, Harlock J, Jegathisawaran J, Goeree R. Economic burden of illness associated with diabetic foot ulcers in Canada. BMC Health Serv Res. 2015 Jan 22;15:13. Lamy A, Tong W, Jung H, Gafni A, Singh K, Tyrwhitt J, Yusuf S, Gerstein HC; ORIGIN Investigators. Cost implication of the use of basal insulin glargine in people with early dysglycemia: The ORIGIN trial. J Diabetes Complications. 2014 Jul-Aug;28(4):553-8. Canadian Institutes of Health Research dissemination grant on high-sensitivity cardiac troponin. Kavsak PA, Jaffe AS, Hickman PE, Mills NL, Humphries KH, McRae A, Devereaux PJ, Lamy A, Whitlock R, Dhesy-Thind SK, Potter JM, Worster A. Clin Biochem. 2014 Nov;47(16-17):155-7.

Lamy A, Tong W, Devereaux PJ, Gao P, Gafni A, Singh K, Taggart D, Straka Z, Akar AR, Piegas L, Ou Y, Yusuf S. The Cost Implications of OffPump Versus On-Pump Coronary Artery Bypass Graft Surgery at One Year. Ann Thorac Surg. 2014 Nov;98(5):1620-5. Mazine A, Teoh K, Bouhout I, Bhatnagar G, Pelletier M, Voisine P, Demers P, Carrier M, Bouchard D. Sutureless aortic valve replacement: a canadian multicentre study. Can J Cardiol. 2015 Jan;31(1):63-8. Paikin JS, Hirsh J, Ginsberg JS, Weitz JI, Chan NC, Whitlock RP, Pare G, Johnston M, Eikelboom JW. Multiple daily doses of ASA overcome reduced platelet response to oncedaily ASA after CABG: A pilot randomized controlled trial. J Thromb Haemost. 2015 Mar;13(3):448-56. Schaub JA, Garg AX, Coca SG, Testani JM, Shlipak MG, Eikelboom J, Kavsak P, McArthur E, Shortt C, Whitlock R, Parikh CR. Perioperative heart-type fatty acid binding protein is associated with acute kidney injury after cardiac surgery. Kidney Int. 2015 Sep;88(3):576-83. Schulman S, Cybulsky I, Delaney J. Anticoagulation for stroke prevention in new atrial fibrillation after coronary artery bypass graft surgery. Thromb Res. 2015 May;135(5):841-5. Stoppe C, McDonald B, Rex S, Manzanares W, Whitlock R, Fremes S, Fowler R, Lamarche Y, Meybohn P, Haberthur C, Rossaint R, Goetzenich A, Elke G, Day A, Helyand DK. Sodium selenite administration in cardiac surgery (SUSTAIN CSX(R)-trial): study design of an international multicentre randomized double-blinded controlled trial of high dose sodium-selenite administration in high-risk cardiac surgical patients. Trials 2014 Aug 28;15(1):339.

Teo KK, Cohen E, Buller C, Hassan A, Carere R, Cox JL, Ly H, Fedak PW, Chan K, LĂŠgarĂŠ JF, Connelly K, Tanguay JF, Ye J, Gupta M, John Mancini GB, Dagenais G, Williams R, Teoh K, Latter DA, Townley R, Meyer SR. Canadian Cardiovascular Society/Canadian Association of Interventional Cardiology/ Canadian Society of Cardiac Surgery Position Statement on RevascularizationMultivessel Coronary Artery Disease. Can J Cardiol. 2014 Dec;30(12):1482-91. Whitlock R, Healey JS, Connolly SJ, Wang J, Danter MR, Tu JV, Novick R, Fremes S, Teoh K, Khera V, Yusuf S. Predictors of early and late stroke following cardiac surgery. CMAJ. 2014 Sep 2;186(12):905-11. Whitlock RP, Healey JS, Holmes DR. Left atrial appendage occlusion debate revisited. Circulation. 2015 Feb 24;131(8):756-61. Zhang WR, Garg AX, Coca SG, Devereaux PJ, Eikelboom J, Kavsak P, McArthur E, ThiessenPhilbrook H, Shortt C, Shlipak M, Whitlock R, Parikh CR; TRIBE-AKI Consortium. Plasma IL-6 and IL-10 Concentrations Predict AKI and Long-Term Mortality in Adults after Cardiac Surgery. J Am Soc Nephrol. 2015 Dec;26(12):3123-32. General Surgery Bell K, Hodgson N, Levine M, Sadikovic B, Zbuk K. Double heterozygosity for germline mutations in BRCA1 and p53 in a woman with early onset breast cancer. Breast Cancer Research Treat 2014 Jul;146(2):447-50. Bradley NL, Bazzerelli A, Lim J, Wu Chao Ying V, Steigerwald S, Strickland M; CAGS Residents' Committee Endoscopy training in Canadian general surgery residency programs. Can J Surg. 2015 Jun;58(3):150-2. Crawford AB, Yang I, Wu RC, Moloo H,

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Publications (July 2014-June 2015) Boushey RP. Dynamic article: combined endoscopic-laparoscopic surgery for complex colonic polyps: postoperative outcomes and video demonstration of three key operative techniques. Dis Colon Rectum. 2015 Mar;58(3):363-9.

Lovrics P, Hodgson N, O'Brien MA, Thabane L, Cornacchi S, Coates A, Heller B, Reid S, Sanders K, Simunovic M. Results of a surgeondirected quality improvement project on breast cancer surgery outcomes in south-central Ontario. Ann Surg Oncol. 2014 Jul;21(7):2181-7.

Del Giudice ME, Vella ET, Hey A, Simunovic M, Harris W, Levitt C. Systematic review of clinical features of suspected colorectal cancer in primary care. Can Fam Physician. 2014 Aug;60(8):e405-15.

Lovrics P, Hodgson N, O’Brien MA, Thabane L, Cornacchi S, Coates A, Heller B, Reid S, Sanders K, Simunovic M. The implementation of a surgeon-directed quality improvement strategy in breast cancer surgery. Am J Surg. 2014 Jul;208(1):50-7.

Del Giudice ME, Vella ET, Hey A, Simunovic M, Harris W, Levitt C. Guideline for referral of patients with suspected colorectal cancer by family physicians and other primary care providers. Can Fam Physician. 2014 Aug;60(8):717-723. Eskicioglu C, Pearsall E, Victor JC, Aarts MA, Okrainec A, McLeod RS. A multifaceted knowledge translation strategy can increase compliance with guideline recommendations for mechanical bowel preparation. J Gastrointest Surg. 2015 Jan;19(1):39-45. Farrokhyar F, Amin N, Dath D, Bhandari M, Kelly S, Kolkin AM, Gill-Pottruff C, Skot M, Reid S. Impact of the Surgical Research Methodology Program on surgical residents’ research profiles. J Surg Educ. 2014 JulAug;71(4):513-20. Li JZ, Kittmer T, Forbes S, Ruo L. Case report: Sigmoid strangulation from evisceration through a perforated rectal prolapse ulcer - An unusual complication of rectal prolapse. Int J Surg Case Rep. 2015;10:238-40. Popovski Z, Mercuri M, Main C, Sne N, Walsh K, Sung M, Rice T, Mertz D. Multifaceted intervention to optimize antibiotic use for intraabdominal infections. J Antimicrob Chemother. 2015 Apr;70(4):1226-9.

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McLeod RS, Aarts MA, Chung F, Eskicioglu C, Forbes SS, Conn LG, McCluskey S, McKenzie M, Morningstar B, Nadler A, Okrainec A, Pearsall EA, Sawyer J, Siddiqui N, Wood T. Development of an Enhanced Recovery After Surgery Guideline and Implementation Strategy Based on the Knowledge-to-action Cycle. Ann Surg. 2015 Dec;262(6):1016-25. Parvez E, Hodgson N, Cornacchi SD, Ramsaroop A, Gordon M, Farrokhyar F, Porter G, Quan ML, Wright F, Lovrics PJ. Survey of American and Canadian general surgeons’ perceptions of margin status and practice patterns for breast conserving surgery. Breast J. 2014 Sep;20(5):481-8. Serrano PE, Grant RC, Berk TC, Kim D, Al-Ali H, Cohen Z, Pollett A, Riddell R, Silverberg MS, Kortan P, May GR, Gallinger S. Progression and management of duodenal neoplasia in familial adenomatous polyposis: A cohort study. Ann Surg. 2015 Jun;261(6):1138-44. Serrano PE, Cleary SP, Dhani N, Kim PT, Greig PD, Leung K, Moulton CA, Gallinger S, Wei AC. Improved Long-Term Outcomes After Resection of Pancreatic Adenocarcinoma: A Comparison Between Two Time Periods. Ann Surg Oncol. 2015 Apr;22(4):1160-7.

Serrano PE, Serra S, Al-Ali H, Gallinger S, Greig PD, McGilvray ID, Moulton CA, Wei AC, Cleary SP. Risk factors associated with recurrence in patients with solid pseudopapillary tumors of the pancreas. JOP. 2014 Nov 28;15(6):561-8. Simunovic MR, Denardi FG, Coates AJ, Szalay DA, Eva KW. Product analysis and initial reliability testing of the Total Mesorectal Excision-Quality Assessment Tool. Ann Surg Oncol. 2014 Jul;21(7):2274-9. Suri RR, Vora P, Kirby JM, Ruo L. Computed tomography features associated with operative management for nonstrangulating small bowel obstruction. Can J Surg. 2014 Aug;57(4):254-9. Wu Chao Ying V, H Kim SH, J Khan K, Farrokhyar F, D'Souza J, Gmora S, Anvari M, Hong D. Prophylactic PPI help reduce marginal ulcers after gastric bypass surgery: A systematic review and meta-analysis of cohort studies. Surg Endosc. 2015 May;29(5):1018-23. Zareba P, Wu C, Agzarian J, Rodriguez D, Kearon C. Meta-analysis of randomized trials comparing compression and anticoagulation with either modality alone for prevention of venous thromboembolism after surgery. Br J Surg. 2014 Aug;101(9):1053-62. Zurita MacĂas Valadez LC, Pescarus R, Hsieh T, Wasserman L, Apriasz I, Hong D, Gmora S, Cadeddu M, Anvari M. Laparoscopic limited Heller myotomy without anti-reflux procedure does not induce significant long-term gastroesophageal reflux. Surg Endosc. 2015 Jun;29(6):1462-8. Neurosurgery Almenawer SA, Badhiwala JH, Alhazzani W, Greenspoon J, Farrokhyar F, Yarascavitch B, Algird A, Kachur E, Cenic A, Sharieff W, Klurfan P, Gunnarsson T, Ajani O, Reddy K, Singh SK, Murty NK. Biopsy versus partial versus gross total resection in older patients with high-

grade glioma: a systematic review and meta-analysis. Neuro Oncol. 2015 2015 Jun;17(6):868-81. Alobaid A, Aref M, Bennardo MR, Farrokhyar F, Reddy K. Facial Nerve Outcome after Vestibular Schwannoma Resection: A Comparative Meta-Analysis of Endoscopic versus Open Retrosigmoid Approach. J Neurol Surg B Skull Base. 2015 Mar;76(2):157-62. Alobaid A, Bennardo MR, Cenic A, Lach B. Mixed capillary-cavernous extramedullary intradural hemangioma of the spinal cord mimicking meningioma: Case report. Br J Neurosurg. 2015 Jun;29(3):438-9. Badhiwala JH, Farrokhyar F, Alhazzani W, Yarascavitch B, Aref M, Algird A, Murty N, Kachur E, Cenic A, Reddy K, Almenawer SA. Surgical outcomes and natural history of intrameduallary spinal cord cavernous malformations: A single-centre series and meta-analysis of individual patient data. J Neurosurg Spine. 2014 Oct;21(4):662-76. Badhiwala JH, Lai CK, Alhazzani W, Farrokhyar F, Nassiri F, Meade M, Mansouri A, Sne N, Aref M, Murty N, Witiw C, Singh S, Yarascavitch B, Reddy K, Almenawer SA. Cervical spine clearance in obtunded patients after blunt traumatic injury: a systematic review. Ann Intern Med. 2015 Mar 17; 162(6):429-37. Baweja R, Mensinkai A, Reddy K, Sahlas DJ. Fornix Infarction after Clipping of Anterior Communicating Artery Aneurysm. Can J Neurol Sci. 2015 May;42(3):205-207. Vora P, Venugopal C, Singh SK. Revealed: The spy who regulates neuroblastoma stem cells. Oncotarget. 2014 Nov 30;5(22):11014-6.

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Publications (July 2014-June 2015) DeMatteo C, Stazyk K, Singh SK, Giglia L, Hollenberg R, Malcolmson CH, Mahoney W, Harper JA, Missiuna C, Law M, McCauley D. Development of a Conservative Protocol to Return Children and Youth to Activity Following Concussive Injury. Clin Pediatr (Phila). July 2015; vol. 54, 8: pp. 783-792.

Ophthalmology Belliveau MJ, Harvey JT. Floppy eyelid syndrome. CMAJ. 2015 Feb 3;187 (2):130.

Lach B, Joshi SS, Murty N, Huq N. Transformation of Merkel cell carcinoma to ganglionueroblastoma in intracranial metastasis. Hum Pathol. 2014 Sep;45(9):1978-81.

Gupta R, Kent JS, Khan YA. Traumatic complete evulsion of the globe and optic nerve. Can J Ophthalmol. 2014 Oct;49(5):e110-2. [PubMed - in process]

Manoranjan B, Singh SK. Letter to the Editor: Temporal evolution of medulloblastoma subgroups. J Neurosurg Pediatr. 2015 Sep;16(3):349-51.

Gupta V, Sabri K, Whelan KF, Viscardi V. Rare case of optic pathway glioma with extensive intra-ocular involvement in a child with neurofibromatosis type 1. Middle East Afr J Ophthalmol. 2015 Jan-Mar;22(1):117-8

Qazi M, Mann A, van Ommeren R, Venugopal C, McFarlane N, Vora P, Singh SK. Generation of murine xenograft models of brain tumors from primary human tissue for in vivo analysis of the brain tumor-initiating cell. Methods Mol Biol. 2014;1210:37-49. Seif GI, Teichman JC, Reddy K, Martin C, Rodriguez AR. Incidence, morbidity, and mortality of Terson syndrome in Hamilton, Ontario. Can J Neurol Sci. 2014 Sep;41(5):572-6. Rathbone AT, Tharmaradinam S, Jiang S, Rathbone MP, Kumbhare DA. A review of the neuro- and systemic inflammatory responses in post concussion symptoms: Introduction of the "post-inflammatory brain syndrome" PIBS. Brain Behav Immun. 2015 May;46:1-16. Reddy D, Fallah A, Petropoulos JA, Farrokhyar F, Macdonald RL, Jichici D. Prophylactic magnesium sulfate for aneurismal subarachnoid hemorrhage: A systematic review and meta-analysis. Neurocrit Care. 2014 Oct;21(2):356-64.).

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Belliveau MJ, Odashiro AN, Harvey JT. YellowOrange Palpebral Spots. Ophthalmology. 2015 Oct;122(10):2139-2140.e1.

Rodriguez AR, Larrazabal Ramiro. Intracranial arteriovenous malformation. N Engl J Med 2015 Jan 15;372(3):e4 (Case report). Seif GI, Teichman JC, Reddy K, Martin C, Rodriguez AR Incidence, morbidity, and mortality of Terson syndrome in Hamilton, Ontario. Can J Neurol Sci. 2014 Sep;41(5):572-6. Yeung SN, Lichtinger A, Kim P, Elbaz U, Ku JY, Teichman JC, Amiran MD, Slomovic AR. Efficacy and safety of patching vs bandage lens on postoperative pain following pterygium surgery. Eye (Lond). 2015 Feb;29(2):295-6. Orthopaedics Aleem IS, Nassr A. Cochrane in CORR ÂŽ: Surgical Versus Non-surgical Treatment for Thoracolumbar Burst Fractures Without Neurological Deficit. Clin Orthop Relat Res. 2016 Mar;474(3):619-24. Ayeni OR, Sansone M, de Sa D, Simunovic N, Bedi A, Kelly BT, Farrokhyar F, Karlsson

Femoro-acetabular impingement clinical research: is a composite outcome the answer? J. Knee Surg Sports Traumatol Arthrosc. 2016 Jan;24(1):295-301.

superior to single-bundle? A comprehensive systematic review. Knee Surg Sports Traumatol Arthrosc. 2015 Mar;23(3):696-739.

Alradwan H, Khan M, Hamel-Smith Grassby M, Bedi A, Philippon MJ, Ayeni OR. Gait and lower extremity kinematic analysis as an outcome measure after femoroacetabular impingement surgery. Arthroscopy. 2015 Feb;31(2):339-344.

Burgers PT, Poolman RW, Van Bakel TM, Tuinebreijer WE, Zielinski SM, Bhandari M, Patka P, Van Lieshout EM; HEALTH and FAITH Trial Investigators. Reliability, Validity, and Responsiveness of the Western Ontario and McMaster Universities Osteoarthritis Index for Elderly Patients with a Femoral Neck Fracture. J Bone Joint Surg Am. 2015 May 6;97(9):751-7.

Banga K, Racano A, Ayeni OR, Deheshi B. Atypical hip pain: Coexistance of femoroacetabular impingement (FIA) and ostoid osteoma. Knee Surg Sports Traumatol Arthrosc. 2015 May;23(5):1571-4. Bhandari M and the FAITH Investigators. Fixation using alternative implants for the treatment of hip fractures (FAITH): Design and rationale for a multi-centre randomized trial comparing sliding hip screws and cancellous screws on revision surgery rates and quality of life in the treatment of femoral neck fractures. BMC Musculoskelet Disord. 2014 Jun 26;15(1):219. Bhandari M, Guyatt GH, Kulkarni AV, Devereaux PJ, Leece P, Bajammal S, Heels-Ansdell D, Busse JW. Perceptions of authors’ contributions are influenced by both byline order and designation of corresponding author. J Clin Epidemiol. 2014 Sep;67(9):1049-54. Bhandari M, Devereaux PJ, Einhorn TA, Thabane L, Schemitsch EH, Koval KJ, Frihagen F, Poolman RW, Tetsworth K, Guerra-Farfán E, Madden K, Sprague S, Guyatt G; HEALTH Investigators. Hip fracture evaluation with alternatives of total hip arthroplasty versus hemiarthroplasty (HEALTH): protocol for a multicentre randomised trial. BMJ Open. 2015 Feb 13;5(2):e006263. Björnsson H, Desai N, Musahl V, Alentorn-Geli E, Bhandari M, Fu F, Samuelsson K. Is doublebundle anterior cruciate ligament reconstruction

Chan K, Macdermid JC, Faber KJ, King GJ, Athwal GS. Can we treat select terrible triad injuries nonoperatively? Clin Orthop Relat Res. 2014 Jul;472(7):2092-9. Chan K, MacDermid JC, Hoppe DJ, Ayeni OR, Bhandari M, Foote CJ, Athwal GS. Delayed vs early motion after arthroscopic rotator cuff repair: A meta-analysis. J Shoulder Elbow Surg 2014 Nov;23(11):1631-9. 12. Chaudhry H, Simunovic N, Petrisor B. Cochrane in CORR: Surgical Versus Conservative Treatment for Acute I njuries of the Lateral Ligament Complex of the Ankle in Adults (Review). Clin Orthop Relat Res. 2015 Jan;473(1):17-22. Chaudhry H, Foote CJ, Guyatt G, Thabane L, Furukawa TA, Petrisor B, Bhandari M. Network Meta-analysis: Users' Guide for Surgeons: Part II – Certainty. Clin Orthop Relat Res. 2015 Jul;473(7):2172-8. Chaudhry H, Kleinlugtenbelt YV, Mundi R, Ristevski B, Goslings JC, Bhandari M. Are Volar Locking Plates Superior to Percutaneous K-wires for Distal Radius Fractures? A Meta-analysis. lin Orthop Relat Res. 2015 Sep;473(9):3017-27.

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Publications (July 2014-June 2015) Chiavaras MM, Jacobson JA, Carlos R, Maida E, Bentley T, Simunovic N, Swinton M, Bhandari M. Impact of platelet rich plasma over alternative therapies in patients with lateral epicondylitis (IMPROVE): Protocol for a multicenter randomized controlled study: A multicenter randomized trial comparing autologous platelet rich plasma, autologous whole blood, dry needle tendon fenestration and physical therapy exercises along on pain and quality of life in patients with lateral epicondylitis. Acad Radiol. 2014 Sep;21(9):1144-55. Creech MJ, Yeung M, Denkers M, Simunovic N, Athwal GS, Ayeni OR. Surgical indications for long head biceps tenodesis: a systematic review. Knee Surg Sports Traumatol Arthrosc. 2016 Jul;24(7):2156-66. Dao D, Sodhi S, Tabasinejad R, Peterson D, Ayeni OR, Bhandari M, Farrokhyar F. Serum 25-Hydroxyvitamin D Levels and Stress Fractures in Military Personnel: A Systematic Review and Meta-analysis. Am J Sports Med. 2015 Aug;43(8):2064-72. de Sa D, Phillips M, Philippon MJ, Letkemann S, Simunovic N, Ayeni OR. Ligamentum teres injuries of the hip:A systematic review examining surgical indications, treatment options and outcomes. Arthroscopy. 2014 Dec;30(12):1634-1641. de Sa D, Alradwan H, Cargnelli S, Thawer Z, Simunovic N, Cadet E, Bonin N, Larson C, Ayeni OR. Extra-articular hip impingement: A systematic review examining operative treatment of psoas, subspine, ischiofemoral and greater trochanteric/pelvic impingement. Arthroscopy. 2014 Aug;30(8):1026-1041. Ebrahim S, Mollon B, Bance S, Busse JW, Bhandari M. A not-so-systematic review: The authors respond. Can J Surg. 2014 Oct;57(5):E152-3.

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de Sa D, Horner NS, MacDonald A, Simunovic N, Ghert MA, Philippon MJ, Ayeni OR. Arthroscopic surgery for synovial chondromatosis of the hip: A systematic review of rates and predisposing factors for recurrence. Arthroscopy. 2014 Nov;30(11):1499-1504.e2. de Sa D, Cargnelli S, Catapano M, Bedi A, Simunovic N, Burrow S, Ayeni OR. Femoroacetabular Impingement in Skeletally Immature Patients: A Systematic Review Examining Indications, Outcomes, and Complications of Open and Arthroscopic Treatment. Arthroscopy. 2015 Feb;31(2):373-384. de Sa D, Cargnelli S, Catapano M, Peterson D, Simunovic N, Larson CM, Ayeni OR. Efficacy of Hip Arthroscopy for the Management of Septic Arthritis: A Systematic Review. Arthroscopy. 2015 Jul;31(7):1358-70. de Sa D, Thornley P, Evaniew N, Madden K, Bhandari M, Ghert M. CHAracteristics of research studies that iNfluence practice: a GEneral survey of Canadian orthopaedic Surgeons (CHANGES): a pilot survey. Springerplus. 2015 Feb 5;4:62. Dehghan N, McKee MD, Nauth A, Ristevski B, Schemitsch EH. Surgical fixation of Vancouver type B1 periprosthetic femur fractures: A systematic review. J Orthop Trauma. 2014 Dec;28(12):721-7. Evaniew N, Noonan V, Fallah N, Kwon BK, Rivers CS, Ahn H, Bailey C, Christie S, Fourney DR, Hurlbert RJ, Linassi G, Fehlings M, Dvorak MF. Methylprednisolone for the treatment of patients with acute spinal cord injuries: A propensity score-matched cohort study from a Canadian multicenter spinal cord injury registry. J Neurotrauma. 2015 Nov 1; 32(21): 1674â&#x20AC;&#x201C;1683.

Evaniew N, Bayegan D, Popovic S, Parasu N, Ghert M. Infrapatellar fat pad osteosacroma: Three cases and a systematic review. J Knee Surg. 2015 Jun;28(3):229-38. Evaniew N, Khan M, Drew B, Peterson D, Bhandari M, Ghert M. Intrawound vancomycin to prevent infections after spine surgery: A systematic review and meta-analysis. Eur Spine J. 2015 Mar;24(3):533-42. Evaniew N, Simunovic N, Karlsson J. Cochrane in CORR®: Viscosupplementation for the treatment of osteoarthritis of the knee. Clin Orthop Relat Res. 2014 Jul;472(7):2028-34. Evaniew N, Simunovic N, McKee MD, Schemitsch E. Cochrane in CORR®: Surgical vs conservative interventions for treating fractures of the middle third of the clavicle. Clin Orthop Relat Res. 2014 Sep;472(9):2579-85. Evaniew N, Yarascavitch B, Madden K, Ghert M, Drew B, Bhandari M, Kwok D. Atlantoaxial instability in acute odontoid fractures is associated with non-union and mortality. Spine J. 2015 May 1;15(5):910-7. Evaniew N, Devji T, Drew B, Peterson D, Ghert M, Bhandari M. The surgical management of scoliosis: a scoping review of the literature. Scoliosis. 2015 Jan 9;10(1):1. Evaniew N, Bhandari M. Cochrane in CORR®: Intramedullary Nails for Extracapsular Hip Fractures in Adults (Review). Clin Orthop Relat Res. 2015 Mar;473(3):767-74. Hak A, Rajaratnam K, Ayeni OR, Moro J, Peterson D, Sprague S, Bhandari M. A Double-Blinded Placebo Randomized Controlled Trial Evaluating Short-term Efficacy of PlateletRich Plasma in Reducing Postoperative Pain After Arthroscopic Rotator Cuff Repair: A Pilot Study. Sports Health. 2015 Jan;7(1):58-66.

Evaniew N, Yarascavitch B, Madden K, Ghert M, Drew B, Bhandari M, Kwok D. A novel approach to patients with acute odontoid fractures: atlantoaxial instability as a prognostic variable. Spine J. 2015 May 1;15(5):1161-3. Evaniew N, Belley-Côté EP, Khan M, Ghert M. The Use of Vancomycin Powder In Modern Spine Surgery: Systematic Review and MetaAnalysis of the Clinical Evidence - Comment. World Neurosurg. 2016 Apr;88:675. Evaniew N, van der Watt L, Bhandari M, Ghert M, Aleem I, Drew B, Guyatt G. Strategies to improve the credibility of metaanalyses in spine surgery: a systematic survey Spine J. 2015 Sep 1;15(9):2066-76. Farrokhyar F, Amin N, Dath D, Bhandari M, Kelly S, Kolkin AM, Gill-Pottruff C, Skot M, Reid S. Impact of the Surgical Research Methodology Program on surgical residents’ research profiles. J Surg Educ. 2014 JulAug;71(4):513-20. Farrokhyar F, Tabasinejad R, Dao D, Peterson D, Ayeni OR, Hadioonzadeh R, Bhandari M. Prevalence of Vitamin D Inadequacy in Athletes: A SystematicReview and Meta-Analysis. Sports Med. 2015 Mar;45(3):365-78. Foote CJ, Chaudhry H, Bhandari M, Thabane L, Furukawa TA, Petrisor B, Guyatt G. Network Meta-analysis: Users’ Guide for Surgeons: Part I - Credibility. Clin Orthop Relat Res. 2015 Jul;473(7):2166-71. IF 2.88 Foote CJ, Guyatt GH, Vignesh KN, Mundi R, Chaudhry H, Heels-Ansdell D, Thabane L, Tornetta P 3rd, Bhandari M. Which Surgical Treatment for Open Tibial Shaft Fractures Results in the Fewest Reoperations? A Network Meta-analysis. Clin Orthop Relat Res. 2015 Jul;473(7):2179-92.

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Publications (July 2014-June 2015) Ghert M, Yao X, Corbett T, Gupta AA, Kandel RA, Verma S, Werier J. Treatment and follow-up strategies in demoid tumours: A practice guideline. Curr Oncol. 2014 Aug;21(4):e642-9. Heaven S, de Sa D, Simunovic N, Williams DS, Naudie D, Ayeni OR. Hip arthroscopy in the setting of hip arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2016 Jan;24(1):287-94. Hussain N, Sprague S, Madden K, Hussain FN, Pindiprolu B, Bhandari M. A comparison of the types of screening tool administration methods used for the detection of intimate partner violence; A systematic review and meta-analysis. Trauma Violence Abuse. 2015 Jan;16(1):60-9. Khan M, Ranawat A, Williams D, Gandhi R, Choudur H, Parasu N, Simunovic N, Ayeni OR. Relationship between the alpha and beta angles in diagnosing CAM-type femoroacetabular impingement on frog-leg lateral radiographs. Knee Surg Sports Traumatol Arthrosc. 2015 Sep;23(9):2595-600. Järvinen TL, Sihvonen R, Bhandari M, Sprague S, Malmivaara A, Paavola M, Schünemann HJ, Guyatt GH. Blinded interpretation of study results can feasibly and effectively diminish interpretation bias. J Clin Epidemiol. 2014 Jul;67(7):769-72. Kau M, Sprague S, Ignacy T, Thoma A, Bhandari M, Farrokhyar F. How to optimize participant retention and complete follow-up in surgical research. Can J Surg. 2014 Dec;57(6):420-7. Khan M, Evaniew N, Bedi A, Ayeni OR, Bhandari M. Arthroscopic surgery for degenerative tears of the meniscus: A systematic review and metaanalysis. CMAJ. 2014 Oct 7;186(14):1057-64.

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Khan M, Simunovic N, Provencher M. Cochrane in CORR®: Surgery for rotator cuff disease (Review) Clin Orthop Relat Res. 2014 Nov;472(11):3263-9. Khan A, Morrison A, Hanley D, Felsenberg D, McCauley L, O'Ryan F, Reid I, Ruggiero S, Taguchi A, Tetradis S, Watts N, Brandi M, Peters E, Guise T, Eastell R, Cheung A, Morin S, Masri B, Cooper C, Morgan S, ObermayerPietsch B, Langdahl B, Al Dabagh R, Davison K, Kendler D, Sándor G, Josse R, Bhandari M, El Rabbany M, Pierroz D, Sulimani R, Saunders D, Brown J, Compston J; behalf of the International Task Force on Osteonecrosis of the Jaw. Diagnosis and Management of Osteonecrosis of the Jaw: A Systematic Review and International Consensus. J Bone Miner Res. 2015 Jan;30(1):3-23. Khan M, Bedi A. Cochrane in CORR ®: Platelet-rich Therapies for Musculoskeletal Soft Tissue Injuries (Review). Clin Orthop Relat Res. 2015 Jul;473(7):2207-13. Kleinlugtenbelt YV, Bhandari M. Cochrane in CORR ®: Interventions for Treating Proximal Humeral Fractures in Adults (Review). Clin Orthop Relat Res. 2015 Sep;473(9): 2750-6. Kowalczuk M, Adamich J, Simunovic N, Farrokhyar F, Ayeni OR. Methodological quality of systematic reviews addressing femoroacetabular impingement. Knee Surg Sports Traumatol Arthrosc. 2015 Sep;23(9):2583-9. Kowalczuk M, Leblanc MC, Rothrauff BB, Debski RE, Musahl V, Simunovic N, Ayeni OR. Posterior tibial translation resulting from the posterior drawer manoeuver in cadaveric knee specimens: a systematic review. Knee Surg Sports Arthrosc. 2015 Oct;23(10):2974-82.

Leblanc MC, Kowalczuk M, Andruszkiewicz N, Simunovic N, Farrokhyar F, Turnbull TL, Debski RE, Ayeni OR. Diagnostic accuracy of physical examination for anterior knee instability: a systematic review. Knee Surg Sports Traumatol Arthrosc. 2015 Oct;23(10):2805-13. MacLeod MG, Hoppe DJ, Simunovic N, Bhandari M, Philippon MJ, Ayeni OR. YouTube as an information source for femoroacetabular impingement: A systematic review of video content. Arthroscopy. 2015 Jan;31(1):136-142. Madden K, Sprague S, Petrisor BA, Farrokhyar F, Ghert MA, Kirmani M, Bhandari M. Orthopaedic Trainees Retain Knowledge After a Partner Abuse Course: An Education Study. Clin Orthop Relat Res. 2015 Jul; 473(7): 2415â&#x20AC;&#x201C;2422. Mak IW, Evaniew N, Popovic S, Tozer R, Ghert M. A translational study of the neoplastic cells of Giant Cell Tumour of Bone following neoadjuvant denosumab. J Bone Joint Surg Am. 2014 Aug 6;96(15):e127. Mak IW, Singh S, Turcotte R, Ghert M. The epigenetic regulation of SOX9 by miR-145 in human chondrosarcoma. J Cell Biochem. 2015 Jan;116(1):37-44. Mascarenhas R, Chalmers PN, Sayegh ET, Bhandari M, Verma NN, Cole BJ, Romeo AA. Is double-row rotator cuff repair clinically superior to single-row rotator cuff repair: A systematic review of overlapping metaanalysis, Arthroscopy. 2014 Sep;30(9):1156-65. Mundi S, Chaudhry H, Bhandari M. Systematic review on the inclusion of patients with cognitive impairment in hip fracture trials: A missed opportunity? Can J Surg. 2014 Aug;57(4):E141-E145.

Paul JE, Nantha-Aree M, Buckley N, Shahzad U, Cheng J, Thabane L, Tidy A, DeBeer J, Winemaker M, Wismer D, Punthakee D, Avram V. Randomized controlled trial of gabapentin as an adjunct to perioperative analgesia in total hip arthroplasty patients. Can J Anaesth. 2015 May;62(5):476-484. Sanders DW, Bhandari M, Guyatt G, HeelsAnsdell D, Schemitsch EH, Swiontkowski M, Tornetta P 3rd, Walter S. The critical sized defect in the tibia: Is it critical? Results from the SPRINT trial. J Orthop Trauma. 2014 Nov;28(11):632. Tan V, Evaniew N, Finlay K, Jurriaans E, Ghert M, Deheshi B, Parasu N. Chronology of the Radiographic Appearances of the Calcium Sulfate-Calcium Phosphate Synthetic Bone Graft Composite 0Following Resection of Bone Tumors: A Follow-up Study of Postoperative Appearances. Can Assoc Radiol J. 2016 Feb;67(1):21-7. Sardana V, Philippon MJ, de Sa D, Bedi A, Ye L, Simunovic N, Ayeni OR. Revision Hip Arthroscopy Indications and Outcomes: A Systematic Review. Arthroscopy.2015 Oct;31(10):2047-55. Slobogean GP, Sprague SA, Scott T, McKee M, Bhandari M. Management of young femoral neck fractures: Is there a consensus? Injury. 2015 Mar;46(3):435-40. Slobogean GP, Sprague SA, Scott T, Bhandari M. Complications following young femoral neck fractures. Injury. 2015 Mar;46(3):484-91. Slobogean GP, Johal H, Lefaivre KA, MacIntyre NJ, Sprague S, Scott T, Guy P, Cripton PA, McKee M, Bhandari M.

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Publications (July 2014-June 2015) A scoping review of the proximal humerus fracture literature. BMC Musculoskelet Disord. 2015 May 10;16(1):112. Sprague S, Slobogean GP, Scott T, Chahal M, Bhandari M. Young femoral neck fractures: Are we measuring outcomes that matter? Injury. 2015 Mar;46(3):507-14. Van der Watt L, Khan M, Rothrauff BB, Ayeni OR, Musahl V, Getgood A, Peterson D. The Structure and Function of the Anterolateral Ligament of the Knee: A SystematicReview. Arthroscopy. 2015 Mar;31(3):569-582.e3. Vignesh KN, McDowall A, Simunovic N, Bhandari M, Choudur HN. Efficacy of ultrasound-guided percutaneous needle treatment of calcific tendinitis. AJR Am J Roentgenol. 2015 Jan;204(1):148-52. Winemaker M, Petruccelli D, Kabali C, de Beer J. Not all total joint replacement patients are created equal: preoperative factors and length of stay in hospital. Can J Surg. 2015 Jun;58(3):160-6. Wong IH, Denkers M, Urquhart N, Farrokhyar F. Construct validity testing of the Arthroscopic Knot Trainer (ArK) Knee Surg Sports Traumatol Arthrosc. 2015 Mar;23(3):906-11. 2013 Jun 25. Zhang S, Paul J, Nantha-Aree M, Buckley N, Shahzad U, Cheng J, DeBeer J, Winemaker M, Wismer D, Punthakee D, Avram V, Thabane L. Reanalysis of morphine consumption from two randomized controlled trials of gabapentin using longitudinal statistical methods. J Pain Res. 2015 Feb 9;8:79-85. Wong IH, Denkers MR, Urquhart NA, Farrokhyar F. Systematic instruction of arthroscopic knot typing with the ArK Trainer: an objective evaluation tool. Knee Surg Sports Traumatol Arthrosc 2015 Mar;23(3):912-8.

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Wood TJ, Racano A, Yeung H, Farrokhyar F, Ghert M, Deheshi BM. Surgical management of bone metastases: Quality of evidence and systematic review. Ann Surg Oncol. 2014 Dec;21(13):4081-9. Yao X, Corbett T, Gupta AA, Kandel RA, Verma S, Werier J, Ghert M. A systematic review of active treatment options in patients with desmoids tumours. Curr Oncol. 2014 Aug;21(4):e613-29. Yeung M, Khan M, Schreiber VM, Adamich J, Letkemann S, Simunovic N, Bhandari M, Musahl V, Philippon MJ, Safran MR, Ayeni OR. Global discrepancies in the diagnosis, surgical management and investigation of femoroacetabular impingement. Arthroscopy. 2014 Dec;30(12):1625-1633. Zhang Y, Tikkinen KA, Agoritsas T, Ayeni OR, Alexander P, Imam M, Yoo D, Tsalatsanis A, Djulbegovic B, Thabane L, SchĂźnemann H, Guyatt GH. Patients' values and preferences of the expected efficacy of hip arthroscopy for osteoarthritis: a protocol for a multinational structured interview-based study combined with a randomised survey on the optimal amount of information to elicit preferences. BMJ Open. 2014 Oct 17;4(10):e005536. Zielinski SM, Keijsers NL, Praet SF, Heetveld MJ, Bhandari M, Wilssens JP, Patka P, Van Lieshout EM. Functional outcome after successful internal fixation vs salvage arthroplasty of patients with a femoral neck fracture. J Orthop Trauma. 2014 Dec;28(12):e273-80. Voineskos SH, Coroneos CJ, Thoma A, Bhandari M. Measuring and understanding treatment effectiveness in hand surgery. Hand Clin. 2014 Aug;30(3):285-292.

Otolaryngology Chan KK, Willan AR, Gupta M, Pullenayegum E. Underestimation of uncertainities in health utilities derived from mapping algorithms involving health-related quality-of-life measures: Statistical explanations and potential remedies. Med Decis Making. 2014 Oct;34(7):863-72. Kelly LE, Sommer DD, Ramakrishna J, Hoffbauer S, Arbab-Tafti S, Reid D, Maclean J, Koren G. Morphine or Ibuprofen for Post-Tonsillectomy Analgesia: A Randomized Trial. Pediatrics. 2015 Feb;135(2):307-13. Moitri MO, Banglawala SM, Archibald J. Red ear syndrome: Literature review and a pediatric case report. 2015 Mar;79(3):281-285. Nayan S, Ramakrishna J, Gupta MK. The proportion of malignancy in incidental thyroid lesions on 18-FDG PET Study: A systematic review and meta-analysis. Otolaryngol Head Neck Surg. 2014 Aug;151(2):190-200. Neighbour H, Goodwin J, Strychowsky J, Rahman S, Abdelshaheed R, Nair P, Sommer DD. Relationship between sputum eosinophilia and sinus disease in patients with eosinophilic bronchitis. Am J Rhinol Allergy. 2014 Sep;28(5):378-82.

Paediatric General Surgery Cameron BH, Martin C, Rambaran M. Surgical training in Guyana: the next generation. Can J Surg. 2015 Feb;58(1):7-9. Flageole HH, Pemberton J. Post-Operative Impact of Nasogastric Tubes on length of stay in infants with pyloric Stenosis (POINTS): A prospective randomized controlled pilot trial. J Pediatr Surg. 2015 Oct;50(10):1681-5. Flageole H, Kanters DM, Tan CN, Pemberton J. The level of evidence keeps improving: An updated analysis of the scientific program at the Canadian Association of Paediatric Surgeons Annual Meeting. J Pediatr Surg. 2015 May;50(5):815-8. Livingston MH, Shawyer AC, Rosenbaum PL, Jones SA, Walton JM. Fundoplication and gastrostomy versus percutaneous gastrojejunostomy for gastroesophageal reflux in children with neurologic impairment: A systematic review and meta-analysis. J Pediatr Surg. 2015 May;50(5):707-14.

Ramakrishna J, Strychowsky J, Gupta M, Sommer DD. Laryngoscope. 2015 Jun;125(6):1472-9.

Livingston MH, Dâ&#x20AC;&#x2122;Cruz J, Pemberton J, Ozgediz D, Poenaru D. Mortality of pediatric surgical conditions in low and middle income countries in Africa. J Pediatr Surg. 2015 May;50(5):760-4.

Sommer DD, Hoffbauer S, Au M, Sowerby LJ, Gupta MK, Nayan S. Treatment of aspirin exacerbated respiratory disease with a low salicylate diet: a pilot crossover study. Otolaryngol Head Neck Surg. 2015 Jan;152(1):42-7.

Livingston MH, Shawyer AC, Rosenbaum PL, Williams C, Jones SA, Walton JM. Glycerin Enemas and Suppositories in Premature Infants: A Meta-analysis. Pediatrics. 2015 Jun;135(6):1093-1106.

Smith KA, Sommer DD, Grondin S, Rotenberg B, Tewfik MA, Kilty S, Wright E, Janjua A, Lee J, Diamond C, Rudmik L. Assessment of the current Canadian rhinology workforce. J Otolaryngol Head Neck Surg. 2015 May 9;44(1):15.

Poenaru D, Pemberton J, Cameron BH. The burden of waiting: DALYs accrued from delayed access to pediatric surgery in Kenya and Canada. J Pediatr Surg. 2015 May;50(5):765-70.

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Publications (July 2014-June 2015) Shawyer AC, D'Souza J, Pemberton J, Flageole H. The management of postoperative reflux in congenital esophageal atresiatracheoesophageal fistula: a systematic review. Pediatr Surg Int. 2014 Oct;30(10):987-96. Shawyer AC, Hatchell AC, Pemberton J, Flageole H. Compliance with published recommendations for postoperative antibiotic management of children with appendicitis: A chart audit. J Pediatr Surg. 2015 May;50(5):783-5. Shawyer AC, Pemberton J, Kanters D, Alnaqi AA, Flageole H. Quality of reporting of the literature on gastrointestinal reflux after repair of esophageal atresia-tracheoesophageal fistula. J Pediatr Surg. 2015 Jul;50(7): 1099-103. Plastics Alolabi N, Chuback J, Grad S, Thoma A. The utility of hand transplantation in hand amputee patients. J Hand Surg Am. 2015 Jan;40(1):8-14. Coroneos CJ, Voineskos SH, Cornacchi SD, Goldsmith CH, Ignacy TA, Thoma A. Users’ guide to the surgical literature: How to evaluate clinical practice guidelines, Can J Surg. 2014 Aug;57(4):280-6. DeMatteo C, Bain JR, Gjertsen D, Harper JA. ‘Wondering and waiting’ after obstetrical brachial plexus injury: Are we underestimating the effects of the traumatic experience on the families? Plas Surg Autumn 2014; 22(3):183-7. Eaves FF 3rd, Thoma A. Introduction to the EBM Hub in the Aesthetic Surgery Journal. Aesthet Surg J. 2015 Jan;35(1):109-10. Hong CJ, Kaur MN, Farrokhyar F, Thoma A. Accuracy and completeness of electronic medical records obtained from referring physicians in a Hamilton, Ontario, plastic surgery practice: A prospective feasibility study. Plast Surg (Oakv). 2015 Spring;23(1):48-50.

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Kau M, Sprague S, Ignacy T, Thoma A, Bhandari M, Farrokhyar F. How to optimize participant retention and complete follow-up in surgical research. Can J Surg. 2014 Dec; 57(6):420-7. Li YK, Alolabi N, Kaur MN, Thoma A. A Systematic Review of Utilities in Hand Surgery Literature. J Hand Surg Am. 2015 May;40(5):997-1005. Ng WK, Kaur MN, Thoma A. Plastic surgeons' self-reported operative infection rates at a Canadian academic hospital. Plast Surg (Oakv). 2014 Winter;22(4):237-40. Panchapakesan V, Zhong T, Forrest CR, Pusic AL, Thoma A. Psychometrics: Essential for Valid, Reliable, and Responsive Measurement in the Development of Patient-reported Outcome Instruments in Plastic Surgery. Plast Reconstr Surg Glob Open. 2015 Jan 8;2(12):e280. Salci KR, Lee JH, Laronde S, Dingwall S, Kushwah R, Fiebig-Comyn A, Leber B, Foley R, Dal Cin A, Bhatia M. Cellular Reprogramming Allows Generation of Autologous Hematopoietic Progenitors From AML Patients That Are Devoid of Patient-Specific Genomic Aberrations. Stem Cells. 2015 Jun;33(6):1839-49. Thoma A, Eaves FF 3rd. Some Random(ized) Thoughts. Aesthet Surg J. 2015 Jul;35(5):627-9. Shortt R, Cooper MJ, Farrokhyar F, Bain JR. Meta-analysis of antibiotic prophylaxis in breast reduction surgery. Canadian Journal of Plastic Surgery 22:2 (Summer 2014): 91-94. Thoma A, Kaur MN, Tsoi B, Ziolkowski N, Duku E, Goldsmith CH. Cost-Effectiveness

Analysis parallel to a Randomized Controlled Trial comparing Vertical Scar Reduction (VSR) and Inverted T-Shaped reduction (ITR) mammoplasty. Plast Reconstr Surg. 2014 Dec;134(6):1093-107. Thoma A, Kaur MN. Response to Letter to the Editor: Cost-Effectiveness Analysis Parallel to a Randomized Controlled Trial Comparing Vertical Scar Reduction and Inverted T Shaped Reduction Mammaplasty. Plast Reconstr Surg. 2015 Jun;135(6): 1061e-1062e. Thoma A. Randomized Controlled Trial Comparing Health-Related Quality of Life in Patients Undergoing Vertical Scar versus Inverted T-Shaped Reduction Mammaplasty. Plast Reconstr Surg. 2014 Oct;134(4):668e-9e. Thoma A, Kaur MN, Hong CJ, Li YK. Methodological guide to adopting new aesthetic surgical innovations. Aesthet Surg J. 2015 Mar;35(3):308-18. Voineskos SH, Coroneos CJ, Thoma A, Bhandari M. Measuring and understanding treatment effectiveness in hand surgery. Hand Clin. 2014 Aug;30(3):285-292. Willand MP, Holmes M, Bain JR, de Bruin H, Fahnestock M. Sensory nerve cross-anastomosis and electrical muscle stimulation synergistically enhance functional recovery of chronically denervated muscle. Plast Reconstr Surg. 2014 Nov;134(5):736e-45e.

Schneider L, Farrokhyar F, Schieman C, Shargall Y, D'Souza J, Camposilvan I, Hanna W. Pneumonectomy: the Burden of Death After Discharge and Predictors of Surgical Mortality. Ann Thorac Surg. 2014 Dec;98(6):1976-82. Schneider L, Farrokhyar F, Schieman C, Hanna WC, Shargall Y, Finley CJ. The burden of death following discharge after lobectomy Eur J Cardiothorac Surg. 2015 Jul;48(1):65-70 IF=2.81 Vernon J, Schieman C, Schneider L, Hanna WC. Rare case of subcarinal thymic carcinoma in the middle mediastinum. J Surg Case Rep. 2015 Mar 25;2015(3). Urology Bhatt MD, Braga LH, Stein N, Terry J, Portwine C. Vaginal Yolk Sac Tumor in an Infant: A Case Report and Literature Review of the Last 30 Years. J Pediatr Hematol Oncol. 2015 Jul;37(5):e336-40. Braga LH, Kim S, Farrokhyar F, Lorenzo AJ. Is there an optimal contralateral testicular cut-off size that predicts monarchism in boys with nonpalpable testicles? J Pediatr Urol. 2014 Aug;10(4):693-8. Braga LH, Lorenzo AJ. The Changing Elaboration of biopsy in Patients with Unilateral Testicular Maldescent vs Vanished Testis. J Urol. 2015 May;193(5):1465-6.

Thoracics Finley CJ. When is the burden of responsibility over for the surgeon? Eur J Cardiothorac Surg. 2016 Feb; 49(2):594-5.

Braga LH, Farrokhyar F, D'Cruz J, Pemberton J, Lorenzo AJ. Risk factors for febrile urinary tract infection in children with prenatal hydronephrosis: a prospective study. J Urol. 2015 May;193(5 Suppl):1766-71.

Hanna WC. Old habits die hard. J Thorac Cardiovasc Surg. 2015 Jan;149(1): 43-4.

Brownrigg N, Pemberton J, Jegatheeswaran K, DeMaria J, Braga LH. A Pilot Randomized

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Publications (July 2014-June 2015) Controlled Trial Evaluating the Effectiveness of Group vs Individual Urotherapy in Decreasing Symptoms Associated with Bladder-Bowel Dysfunction. J Urol. 2015 Apr;193(4):1347-52.

Hill B, De Melo J, Yan J, Kapoor A, He L, Cutz JC, Feng X, Bakhtyar N, Tang D. Common reduction of the Raf kinase inhibitory protein in clear cell renal cell carcinoma. Oncotarget. 2014 Sep 15;5(17):7406-19.

de Bessa J Jr, de Carvalho Mrad FC, Mendes EF, Bessa MC, Paschoalin VP, Tiraboschi RB, Sammour ZM, Gomes CM, Braga LH, Bastos Netto JM. Antibiotic prophylaxis for prevention of febrile urinary tract infections in children with vesicoureteral reflux: a meta-analysis of randomized, controlled trials comparing dilated to nondilated vesicoureteral reflux. J Urol. 2015 May;193(5 Suppl):1772-7.

Hopmans SN, Duivenvoorden WC, Werstuck GH, Klotz L, Pinthus JH. GnRH antagonist associates with less adiposity and reduced characteristics of metabolic syndrome and artherosclerosis compared with orchiectomy and GnRH agonist in a preclinical mouse model Urol Oncol. 2014 Nov;32(8):1126-34.

Fradet V, Mauermann J, Kassouf W, Rendon R, Jacobsen N, Fairey A, Izawa J, Kapoor A, Black P, Tanguay S, Chin J, So A, Lattouf JB, Bell D, Saad F, Sheyegan B, Drachenberg D, Cagiannos I, Lacombe L. Risk factors for bladder cancer recurrence after nephroureterectomy for upper tract urothelial tumours: Results from the Canadian Upper Tract Collaboration. Urol Oncol. 2014 Aug;32(6):839-45.

Lucca I, Kassouf W, Kapoor A, Fairey A, Rendon RA, Izawa JI, Black PC, Fajkovic H, Seitz C, Remzi M, NyirĂĄdy P, RouprĂŞt M, Margulis V, Lotan Y, de Martino M, Hofbauer SL, Karakiewicz PI, Briganti A, Novara G, Shariat SF, Klatte T. The role of adjuvant chemotherapy for lymph node-positive upper tract urothelial carcinoma following radical nephroureterectomy: a retrospective study. BJU Int. 2015 Jul;116(1):72-8.

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Zareba P, Patterson L, Pandya R, Margel D, Hotte SJ, Mukherjee SD, Elavathil L, Daya D, Shayegan B, Pinthus JH. Thromboembolic events in patients with urothelial carcinoma undergoing neoadjuvant chemotherapy and radical cystectomy. Urol Oncol. 2014 Oct;32(7):975-80. Pinthus JH. Uncovering the Metabolic Complications of Androgen Deprivation Therapy in Patients with Prostate CancerWhere Do We Take it Next? J Urol. 2015 Jun;193(6):1882-3. Ploussard G, Xylinas E, Lotan Y, Novara G, Margulis V, RouprĂŞt M, Matsumoto K, Karakiewicz PI, Montorsi F, Remzi M, Seitz C, Scherr DS, Kapoor A, Fairey AS, Rendon R, Izawa J, Black PC, Lacombe L, Shariat SF, Kassouf W. Conditional survival after radical nephroureterectomy for upper tract carcinoma. Eur Urol. 2015 Apr;67(4):803-12.

Rybak AP, Bristow RG, Kapoor A. Prostate cancer stem cells: deciphering the origins and pathways involved in prostate tumorigenesis and aggression. Oncotarget. 2015 Feb 10;6(4):1900-19. Vascular Simunovic MR, Denardi FG, Coates AJ, Szalay DA, Eva KW. Product analysis and initial reliability testing of the Total Mesorectal Excision-Quality Assessment Tool. Ann Surg Oncol. 2014 Jul;21(7):2274-9. Hopkins RB, Burke N, Harlock J, Jegathisawaran J, Goeree R. Economic burden of illness associated with diabetic foot ulcers in Canada. BMC Health Serv Res. 2015 Jan 22;15:13.

Warkentin TE, Sheppard JA, Chu FV, Kapoor A, Crowther MA, Gangji A. Plasma exchange to remove HIT antibodies: dissociation between enzyme-immunoassay and platelet activation test reactivities. Blood. 2015 Jan 1;125(1):195-8. Wong NC, Braga LH. The influence of pre-operative hormonal stimulation on hypospadias repair.Front Pediatr. 2015 Apr 22;3:31.. eCollection 2015. Review. Zareba P, Wu C, Agzarian J, Rodriguez D, Kearon C. Meta-analysis of randomized trials comparing compression and anticoagulation with either modality alone for prevention of venous thromboembolism after surgery. Br J Surg. 2014 Aug;101(9):1053-62.

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Acknowledgements A special thank-you to all those who have contributed to the preparation of the 2015-2016 Status Report! Dr. Susan Reid, Chair Dr. Mohit Bhandari, Associate Chair of Research Dr. Stephen Kelly, Associate Chair of Education Program Coordinators Division Heads Administrative Staff Edowed Chairs Education Groups Research Groups Dr. Hansebout

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