No fast -track for Montreal Medical Students

Montreal's two medical schools have thrown cold water on a proposal to fast-track the education of medical students to save money and help reduce the shortage of doctors.

An editorial in the latest issue of the Canadian Medical Association Journal recommends that the standard four-year curriculum be reduced by a year.

But officials at both McGill University and the Université de Montréal argue the proposal doesn't make sense in Quebec because many students in the province enroll in medical school straight out of CEGEP.

In the other provinces, most medical students already have an undergraduate degree in the sciences.

"CEGEP students have two years of schooling, and it doesn't make sense for them to then have only three years of medical education," said Raymond Lalande, vice-dean of undergraduate studies in the faculty of medicine at U de M.

He noted that 40 percent of U de M's medical students do not have an undergraduate degree, and at the Université de Sherbrooke, the proportion is 80 percent.

"We risk lowering the quality of medicine by doing this," Lalande added.

The editorial by three doctors observed that McMaster University in Hamilton, and the University of Calgary have for years offered three-year programs.

"Is this extra year necessary?" the editorial asked. "Training each medical student in Canada is costly both in time and money. Each student requires hundreds of hours of time from established family physicians, specialists and medical educators - time that otherwise could be spent on caring for patients."

By graduating students earlier, the editorial suggested, newly-trained doctors would be able to provide an additional year of care.

Joyce Pickering, associate dean of medical education at McGill, said any decision to shorten the school curriculum in Quebec would have to reflect the CEGEP system of junior colleges.

"We'd have to look at whether or not the rules would be different for students who come directly from CEGEP as opposed to students who have (an undergraduate) degree first."

At the U de M's medical school, students must study for 180 weeks. U de M medical students tend to score the highest overall marks in the country in year-end exams by the Medical Council of Canada.

In contrast, the programs at McMaster and Calgary are 130 weeks long - the minimum required to earn a medical degree. McGill's program lasts 160 weeks.

The Association of Faculties of Medicine of Canada, representing the country's 17 medical schools, is reviewing the standard curriculum in addition to the three-year proposal.

Its recommendations are due in 2009. If any decision is taken to reduce the curriculum by a year, it probably won't occur until five years from now, Pickering said, because of the lead time it takes to make changes of this nature.

Lalande said that the trend in medicine is to length the residencies of specialties like pediatrics and neurosurgery, not shorten them.

Before being being allowed to practise on their own, doctors must complete residency training in a hospital. For family medicine, it's two years. But for specializations, it's at least three years.

"Honestly, I can't see how three years of medical school, followed by a two-year residency in family medicine, is enough to train a family doctor to respond to all the needs of patients and an aging population," Lalande said.

"Any proposal to change the curriculum has to be made for pedagogical reasons. This proposal is being made for non-medical reasons."

The Quebec government has gradually increased enrollment in medical schools since 2003. Health Minister Philippe Couillard said the province will report a net increase of 1,200 doctors by 2012.

Source: The Gazette

Major investments in Health Care in Calgary and Edmonton

The Alberta Cunstruction Magazine reports there's a lot of work to be done in the years to come.

For Health and Wellness for just the two regions, there’s more than $1.6 billion worth of work. For advanced education, there’s $250 million for Calgary and more than $400 million for Edmonton over the next four years.

A number of factors are driving the construction boom in health care facilities: an aging population, an increase in population in high-growth areas such as Fort McMurray, and a desire to keep Alberta on the leading edge in research, technology, and world-class facilities.

The Alberta government reports funding for Health and Wellness is up $1.3 billion (12.2 per cent) for the 2007–08 budget year.
Over the next three years, the Alberta government has slated $2.6 billion for health facilities, including $250 million to replace the Queen Elizabeth Hospital in Grande Prairie, $221 million to cover cost escalation on health projects that have already been approved, and $26.4 million for the Northern Lights Health Region to build infrastructure for health care providers in the regions and new community health clinics.
In addition, a helicopter platform will be added at the Northern Lights Regional Health Centre.

Money will also go towards 30 previously approved projects.
Those include construction of community health centres in Red Deer, Calgary, and Edmonton, as well as long-term care facilities in Red Deer, Edmonton, High Prairie, Vermilion, and Vegreville.

The new multi-use facilities will offer excellence in health care for patients and learning opportunities for post-secondary students.

For instance, the Edmonton Clinic, a partnership between Capital Health and University of Alberta, models itself after the Mayo Clinic, a one-stop shop that houses multiple clinics in one place.
Construction, expected to open in 2011 at a cost of $909 million, begins this year.

In Calgary, 2008 marks the first full year of work on the $1.25-billion South Health Campus. The campus will bring together wellness, health research and education on a 44-acre campus located at Deerfoot Trail and 196th Avenue SE.

The 160,000 sq.m health campus will consist of heath services, including surgery and operating rooms, pediatrics, obstetrics, mental heath, as well as emergency and outpatient services. It will also focus on wellness services and research and education. Phase I is scheduled to open in the spring of 2011.

Calgary moms and company owners recall gourmet baby food

A small company, run by two Calgary mothers is voluntarily recalling some of its gourmet baby food after the Canadian Food Inspection Agency warned the product could harm children with severe peanut allergies.

Some Baby Gourmet products may contain peanut protein or sulphites not mentioned on the label, said the warning issued last Monday.

The baby foods in question include organic Moroccan lamb with couscous, which might contain undeclared peanut protein, and seasonal fruit compote, which contains undeclared sulphites, said Garfield Balsom, a food safety and recall specialist with the food and inspection agency.

Peanuts are not used in any of the locally made foods, but the dried couscous could have come in contact with peanuts in the packing plant before being sent to Calgary, said Jennifer Broe, who launched the company with her sister two years ago.

So far, only one allergic reaction has been reported in connection to Baby Gourmet products. Calgary Health Region officials said Monday the patient suffered an allergic reaction caused by the peanut protein in the product. The patient was treated at a physician's office and did not require hospitalization.

The recall involves foods that were sold at the Calgary Farmer's Market and at Mise en Place in Lakeview Plaza. The products have only been distributed in Calgary.

There has been one reported illness associated with the products, which are common food allergens.

The recipes included in the recall will be discontinued until Baby Gourmet can finish a thorough investigation of all ingredients, said Broe.

"We make this food like it's for our own children. We will definitely take every precaution to look into the recipes and research all the ingredients to make sure everything is listed," she said.

Source: Canada.com

Death Calgary baby raises awareness need for bone marrow and blood donors

The heartbreaking story of a baby from Calgary called Evan Pogubila who died from a rare immunodeficiency disease, captivated the whole of Calgary this year.

While the Pogubila family is still coping with grief, Evan has left behind a legacy his family is carrying forward, increasing awareness of the need for blood and bone marrow donors to help save lives.

"It's just before bedtime, but little Jordan Pogubila shows no signs of slowing down for the night. Wearing a pink sleeper covered in butterflies, her strawberry blond hair cut into an adorable bob, she captivates all around her as she dances to the pop song playing on her parents' stereo," says her mom Melanie as she smiles at her exuberant toddler.

If life had gone the way it should, the 19-month-old's twin brother Evan would be right beside her, bopping along to the music in that amusing toddler way.

Instead, a box sitting on the living room side table, his photograph on the outside and his cremains within, look down upon this happy family scene.

Last June 26th, the wide-eyed heart breaker of a baby died, after a courageous battle against severe combined immunodeficiency disease, also known as SCIDs.

Evan was the only known child in Western Canada with SCIDs, a condition first brought to the public eye in 1976 in a TV movie called The Boy in the Plastic Bubble.

Like David Vetter, the real-life boy who inspired the film, Evan spent most of his short life living in solitude from the rest of the world.

Caused by a genetic defect, the condition is the most rare, and deadliest, of the primary immunodeficiencies.
Any contact with others, including his twin Jordan, could compromise what little immune system Evan had.

Read the full article here

Calgary Counselling Centre threatened to loose its residence

The Calgary Counselling Centre, since 1962, has provided counselling programs to help individuals, families, couples, children, men and women resolve domestic abuse, depression, stress, emotional and social programs.
Last year, the non-profit organization served 6367 clients, through 32,264 hours of counselling.

Through its ongoing research and education program, Calgary Counselling Centre strives to meet the changing needs of the community.

Now, with 10 working days notice, the Calgary Counselling Centre is in jeopardy of losing the space they have leased and occupied since June 1992.

Mid way through a ten year lease, the Calgary Counselling Centre has been advised that its lease may be terminated on coming 31 December.

Editor's opinion:

"Is it coincidence or well planned that health care workers are being told life changing bad news just before Christmas?
Earlier this week I already reported about the Victorian nurses in Hamilton who were told they'd loose their jobs coming April.
What is it with these people, these bringers of bad news?
Do they think that those people won't kill themselves around Christmas when around family and friends?
A happy Christmas to you too, you inconsiderate @%%40!e5"

Government grants $5.36 million to Alberta's Health and Wellness

Lee Richardson, Member of Parliament for Calgary Centre, on behalf of the Honourable Tony Clement, Minister of Health, and the Honourable Diane Finley, Minister of Citizenship and Immigration, today announced a federal contribution of $536,000 to Alberta Health and Wellness to pilot test an innovative off-shore assessment program for internationally educated nurses immigrating to Canada.

"Projects such as this will help to alleviate Canada's nursing shortage, which in turn will lead to improved care and a reduction in wait times. This is a ground-breaking initiative, in which the Government of Canada is proud to take part," said Minister Clement.

"Canada has a skills shortage and skilled immigrants want to contribute to our country by working in the fields for which they've been trained. We want to help them do that and one of the best ways is to help them get their credentials assessed before they enter the country so that when they arrive, they can find work faster in their fields," said Minister Finley.

Traditionally, internationally educated nurses who wanted to work in Alberta needed to travel to Mount Royal College in Calgary to take the assessment exams. Once this off-shore pilot project is fully implemented, 36 nursing candidates will be assessed overseas, with their language, knowledge and competencies measured against Registered Nurse (RN) competency standards. The nurses will be informed of any areas that require supplemental learning.

"I am thrilled that this project is taking place here in Alberta," said Mr. Richardson. "Internationally trained nurses can now be assessed before they arrive to Alberta, so that when they arrive they'll be able to start working as nurses sooner."

Read the rest of the story here

Who's watching you when you're under the scalpel?

Under the cover of blankets and the cloud of anesthetic, surgical patients give themselves over to doctors and nurses charged with their care.

Hours later, they may wake up in a recovery room without realizing someone other than the surgical team was present for their operation.

Representatives from medical device companies sometimes attend surgeries. They offer doctors technical advice on the heart pumps and orthopedic implants and a litany of other products they sell to hospitals.

In Calgary, patients are often unaware of the practice, in part because local hospitals don't require specific consent for a company representative to attend an operation, a fact some observers find troubling.

"You have to be really sensitive to people's privacy and their right to know who's involved with their care," says Dr. Guido Van Rosendaal, a physician and University of Calgary health policy researcher.

Experts say this is just one example of how the influence of device manufacturers and pharmaceutical companies in hospitals reaches further than many patients realize.

Industry's role in hospitals is at the centre of a national ethics debate after a recent Canadian Medical Association Journal article examined a B.C. health authority's new policy around sales representatives in its medical facilities.

The journal reported that Fraser Health brought in the rules after discovering some pharmaceutical sales people were paying surgeons an honorarium or educational grant to allow them to attend surgeries, a practice that is prohibited in Calgary.

Still, the changes at Fraser Health have some observers taking a close look at what industry practices are allowed in Calgary hospitals.

"There's a larger question in terms of what really is the role of sales reps in hospitals," says Barbara Mintzes, an assistant University of British Columbia professor, who studies pharmaceutical marketing practices. "Are some of these promotional activities leading to less appropriate patient care?" But the association representing Canada's research-based pharmaceutical companies argues their sales representatives have a role to play in medical facilities.

"We're making sure health-care professionals know the best information about prescription medications," says Russell Williams, president of Rx & D.

The debate follows the new Fraser Health policy, instituted this fall, that stops sales representatives from leaving samples of new drugs and other products at hospitals. It also bans salespeople from clinical areas such as operating rooms, unless they have permission.

The Calgary Health Region has a similar rule prohibiting pharmaceutical salespeople from meeting with physicians in any patient-care areas of hospitals. Representatives are not allowed to leave free samples of new products in CHR hospitals.

But Fraser Health's policy goes further than Calgary's, requiring vendors to receive an identification badge and "certification" when they arrive at a hospital.

The CHR has no such central intake process for salespeople, though officials concede some representatives occasionally wander into areas of the hospital where they are not allowed.

Steve Long, the CHR's director of pharmacy integration and strategic programs, says the health region contemplated introducing such controls, but decided against it because "we don't see there's an issue or problem." Calgary's policies also differ in one other significant way: CHR hospitals do not require explicit patient consent for a vendor to attend surgery, which is mandatory in Fraser Health hospitals.

Experts like the University of Calgary's Van Rosendaal say local hospitals should reconsider this practice.

CHR officials say vendors follow procedures to protect patient privacy and are only present in operating rooms to provide technical assistance.

"A vendor wouldn't be allowed into the room before a patient is draped and they talk about confidentiality," says Shanda Naylor, the CHR's director of perioperative services.

Officials with Rx & D, the association that represents the country's 50 research-based pharmaceutical companies, say they've banned gifts such as buying a round of golf for a doctor.

"We don't pay for access to medical professionals," says Williams of Rx & D.

Rx & D does permit companies to sponsor training activities for medical professionals and some Calgary doctors say they have little choice but to rely on such support for continuing medical education.

Dr. Debra Isaac, director of cardiac transplants for CHR, says sponsorships from industry allow her to hold training events where she can rent a venue, bring in speakers and even serve a meal. A session in rural Alberta, for example, might teach small-town doctors about treating heart failure.

Without the industry sponsorships, Isaac said, the events wouldn't happen.

"There's just no government funding, no hospital funding," says Isaac. "At this point, we'd be very limited without it." Experts like Mintzes say more public funding should be available to ensure continuing medical education is conducted at arm's length from pharmaceutical companies.

Mintzes also believes industry's self-regulation is problematic, arguing there have been cases where pharmaceutical companies paid for access to doctors, which is prohibited by Rx & D's code.

For now, however, it's left to industry and healthcare providers to find the right balance.

In Calgary, health officials say they have a strong set of rules in place to govern physicians' involvement with pharmaceutical companies.

Calgary Herald

Editor:

Steve Long, the CHR's director of pharmacy integration and strategic programs:
"we don't see there's an issue or problem."

So don't we, after all: we're unconscious!