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Funding new scientific frontiers

New Frontiers in Research Fund fuels Queen’s research in topics ranging from Lyme disease to climate change.

Early-career researchers are the backbone of Canada’s research infrastructure. Recognizing this area of research strength and its potential, the Government of Canada has launched the New Frontiers in Research Fund (NFRF) to support early-career researchers as they pursue the next great discovery in their fields.

[Minister Kirsty Duncan]
Kirsty Duncan, Minister of Science and Sport

Seven Queen’s University projects earned a $1.72 million portion of the $38 million in NFRF funding announced by the Honourable Kirsty Duncan, Minister of Science and Sport, earlier this week. The successful Queen’s researchers are: Chantelle Capicciotti (Chemistry) and Mark Ormiston (Biomedical and Molecular Sciences), Robert Colautti (Biology), Samuel Dahan (Law), Lindsay Morcom (Education), Jessica Selinger (Kinesiology and Health Science), Kevin Stamplecoskie (Chemistry), and Laura Thomson (Geography and Planning).

“I am pleased today to celebrate the very first researchers to benefit from the New Frontiers in Research Fund. Our government’s vision is for our researchers to take risks and be innovative,” says Minister Duncan. “We want our scientists and students to have access to state-of-the-art laboratories and equipment, and we want the halls of academia to better reflect the diversity of Canada itself. This new fund will help us achieve that vision.”

Drs. Capicciotti and Ormiston are studying how cancer cells change the sugars that they express on their surface to avoid detection by the immune system. The researchers will work to develop technology to screen hundreds of sugar structures, with the ultimate goal of creating new cancer therapies that function by boosting an individual’s immune response.

As a member of the Canadian Lyme Disease Research Network (CLyDRN) based at Queen’s, Dr. Colautti is leading a diverse and multidisciplinary group of researchers to disrupt the way that tick-borne diseases are identified and managed in Canada. Their approach includes the use of handheld DNA sequencers and cloud computing for rapid detection of known or potential tick-borne pathogens, summarizing this information into a risk assessment framework for medical practitioners, public health officials, and the general populace.

Professor Dahan, in collaboration with Xiaodan Zhu (Electrical and Computer Engineering) and a team of 25 data scientists, Artificial Intelligence researchers, and law students, is working on an open source AI-tribunal for small claims in Ontario. This digital dispute-resolution platform will provide predictive legal services and negotiation support for self-represented plaintiffs. The NFRF funding will help develop the first stage of the product, focusing on severance pay and termination negotiation.

Using the skills of an interdisciplinary team of Indigenous and non-Indigenous scholars and visual and digital media artists, Dr. Morcom and her team will work to create a network of virtual reality spaces across the country. The newly-created spaces will be used to stage cross-cultural, interdisciplinary, and cross-generational encounters.

Dr. Selinger has formed an interdisciplinary team that combines expertise in fundamental human biomechanics, clinical rehabilitative medicine, and applied robotic control. The research has the potential to revolutionize the next generation of rehabilitation strategies by focusing on how people re-learn to walk after a stroke.

Focusing on a new area of research, Dr. Stamplecoskie and partner Guojun Liu (Chemistry), are researching new electrochemical devices, capable of capturing the tremendous amount of energy available in rainfall, waves, and evaporating water. The research is working to create new devices capable to meeting global energy demands.

Dr. Thomson has amassed an interdisciplinary team that will integrate modern glacier research practices and inter-generational perspectives on climate, to improve environmental monitoring in Canada’s high-Arctic. This initiative will provide open-access, real-time climate data for the first time in this part of the Arctic, and provide public access to rare historic data.

All of the Queen’s projects are funded under the Exploration stream of the NFRF program. The second stream is the Transformation stream that provides large-scale support for Canada to build strength and leadership in interdisciplinary and transformative research. The third stream, International, will come online later, according to Minister Duncan.

“Through the NFRF program, early-career researchers at Queen’s are bringing new ideas and methodologies to critical issues from Lyme disease to climate change,” say Kimberly Woodhouse, Interim Vice-Principal (Research). “Importantly, they are increasing the potential impact and application of their work by collaborating across disciplinary boundaries.”

For more information, visit the NFRF website.

Don’t miss out on research funding opportunities, subscribe to the University Research Services Funding Opportunities listserv.

Queen’s names first Distinguished University Professors

Recipients recognized for international research and teaching excellence.

2018-19 Distinguished University Professors
2018-19 Distinguished University Professors: (Left to right) Top row: Donald H. Akenson, Stephen Archer, Nicholas Bala. Middle row: Susan P. C. Cole, Cathleen Crudden, John McGarry. Bottom row: Ram Murty, R. Kerry Rowe, Suning Wang.

Queen’s University recently awarded its highest research-related honour to nine faculty members internationally recognized for contributions to their respective fields of study. Each recipient was named a Distinguished University Professor for exhibiting an outstanding and sustained research record, teaching excellence, and significant and lasting contributions to Queen’s, Canada, and the world.

“The work being done here at Queen’s in many different academic disciplines is contributing to our understanding of the world and the overall global body of knowledge in many fields,” says Daniel Woolf, Principal and Vice-Chancellor. “To celebrate this level of world-class excellence in research and teaching, it is my pleasure to designate nine of our most accomplished faculty members as Distinguished University Professors.”

The group of individuals chosen are the first to receive designations under the Distinguished University Professor Program, which was made official by the university’s Senate in 2017-18. Each year, the program’s advisory committee will invite nominations from the campus community, review the submissions, and make recommendations to the principal, who then determines successful nominees.

“Choosing this year’s recipients, from what was an impeccable pool of nominees, was no easy task,” says Principal Woolf. “That said, it served as a wonderful opportunity for me to learn even more about the breadth of work taking place here at Queen’s, and the incredible faculty driving it forward.”

Each recipient will soon add an honorific name to their title, to be selected from a list of Senate approved names. For the first set of designates, this process will take place shortly.

The inaugural group of Distinguished University Professors includes:

  • Donald H. Akenson, Distinguished University Professor, Department of History
  • Stephen Archer, Distinguished University Professor, School of Medicine
  • Nicholas Bala, Distinguished University Professor, Faculty of Law
  • Susan P. C. Cole, Distinguished University Professor, Queen’s Cancer Research Institute
  • Cathleen Crudden, Distinguished University Professor, Department of Chemistry
  • John McGarry, Distinguished University Professor, Department of Political Studies
  • Ram Murty, Distinguished University Professor, Department of Mathematics and Statistics
  • R. Kerry Rowe, Distinguished University Professor, Department of Civil Engineering
  • Suning Wang, Distinguished University Professor, Department of Chemistry

Visit the Principal’s website to learn more about the Distinguished University Professors Program, its advisory committee, and selection of honorific names.

A Hall of Fame career

This article was first published on the Faculty of Health Sciences Dean’s Blog.

On May 2, I had the thrill of attending the induction ceremony for the Canadian Medical Hall of Fame. This is one of my favourite annual events, and this year’s ceremony was especially meaningful because I was able to see a true legend of the Queen’s School of Medicine get inducted: Dr. Jackie Duffin.

From 1988 to 2017, Dr. Duffin was the Jason A. Hannah Chair in the History of Medicine at Queen’s, and in this role she taught all of our medical students to place our profession in a broader historical context and also to think critically about the ways in which medical knowledge is produced.

A number of the lessons she created for our curriculum became rites of passage for our students. I think almost everyone who studied here while Dr. Duffin taught for us has vivid memories of reading the original Hippocratic Oath with her during orientation and thinking hard about the concepts of “heroes” and “villains” in medical history during their first semester. Many students also traveled around Canada and the United States with her, as she arranged yearly field trips to medical museums in both countries.

Dr. Duffin’s students were so devoted to her that some of them created a conference in her honour the year after she retired. The Jacalyn Duffin Health and Humanities Conference has now run for two years, and it has been an outstanding success both times.

In its citation for Dr. Duffin’s induction, the Canadian Medical Hall of Fame says, “A haematologist and historian, her enduring contributions to medical research and education deepen our understanding of how the humanities inform balanced, effective medical training.”  

[Dr. Jackie Duffin]
Jackie Duffin, seated, front row, last on right, was inducted into the Canadian Medical Hall of Fame on May 2. (Supplied Photo)

It is so terrific to see Dr. Duffin honoured for the way in which she has so effectively brought the humanities into medical education because, at Queen’s, we’ve been seeing for decades the positive effects that this kind of teaching can have on students.

Because I know how beloved she always was by our students, I reached out to a few to ask for their thoughts on Dr. Duffin and what she has meant to them. Here’s what they had to say.

“Dr. Duffin’s History of Medicine curriculum has provided an essential building block to the medical education of thousands of medical students,” Kate Rath-Wilson says. “She provided us with the critical reasoning tools to be skeptical when necessary and righteous in our advocacy. Learning about the history of our profession, its triumphs and tragedies, through Dr. Duffin’s critical lens was at once humbling and empowering. Her teaching discouraged us from becoming complacent in our responsibilities as health care advocates in our future careers.”

"There are few generalizations that are true in life but I can say without any reservation that Dr. Jacalyn Duffin is loved and cherished by ALL her students,” says Hissan Butt. “That's why Meds 2015 established the Jacalyn Duffin Student Award and students from Meds 2020 and 2021 started an eponymous health humanities conference. It's been an absolute privilege to learn from her and ask important questions about medicine and society."

I’d also like to point out that Hissan was also in Montreal for the induction ceremony, as he was receiving a Canadian Medical Hall of Fame Award. These awards recognize terrific work being done by a student at each medical school in Canada, and all of us in the School of Medicine are very proud of Hissan for being this year’s recipient from Queen’s.

“I always cherish moments in the lecture hall with Dr. Duffin,” Yannay Khaikin says. “She teaches with a kind of energy and honesty that reverberates for decades in the minds of medical students, residents, and faculty who have been fortunate to hear her speak. Her commitment to preserving the study of philosophy and history in medicine is relentless, unapologetic, and utterly unique.”

“Dr. Duffin has been the most influential and impactful teacher in both my medical and non-medical education,” Chantal Valiquette says. “She is a resilient, passionate, and brilliant historian/physician who is a constant source of inspiration to her students. Her dedication to her students is unparalleled, and her support for history of medicine has inspired generations of students to realize the impact our history has on our present day understandings of medicine and medical education. There is no one more deserving of an induction to the Canadian Medical Hall of Fame.”

“Equipped with a colourful scarf, her signature round glasses, a pair of neon sneakers and an exuberance that knows no bounds, Dr. Jackie Duffin is unlike any other professor I have ever had,” Harry Chandrakumaran says. “It is obvious to even the least attentive student that she is unapologetically in love with her job. I cannot imagine a more deserving candidate for induction into the Canadian Medical Hall of Fame. Many doctors have testified in court. Rarely have they had their testimony result in the canonization of a saint. Even more impressive than meeting the Pope, Dr. Duffin manages to engage a hundred medical students while discussing the intricacies of 16th century anatomical illustrators. Perhaps that is why she is so fondly remembered by a generation of physicians.”

 The Hannah Chair is funded by a program that was established by Associated Medical Services (AMS) to promote the history of medicine in curricula at medical schools across Canada. AMS funds eight Hannah Chairs at Canadian universities: six in Ontario, one in Alberta, and one in Quebec.

The Hannah Chair program is a fantastic contribution to Canadian medical education, and, at Queen’s, we have always been proud to host a Chair. While Dr. Duffin no longer teaches our students, they are still learning just as much about the history of medicine through our new Hannah Chair: Dr. Jenna Healey.

As I said, the Canadian Medical Hall of Fame induction ceremony is a tremendous event every year. I have fond memories of hosting the event in Kingston in 2014, and this year had the pleasure of sitting with Dr. Duncan Sinclair, a former dean at Queen’s and a 2015 inductee into the Hall of Fame. Thanks to everyone at the Canadian Medical Hall of Fame for hosting a wonderful evening in Montreal and for all of the work you do to recognize medical achievements in Canada.

If you're curious to read Dr. Duffin's thoughts on being inducted, please check out her most recent blog entry.

Dean Reznick thanks Andrew Willson for his assistance in preparing this blog. 

Interactive sessions focus on Calls to Action of the Truth and Reconciliation Commission

In support of Queen’s University’s ongoing effort to help answer to the Calls to Action of the Truth and Reconciliation Commission, the Faculty of Health Sciences is hosting a series of interactive sessions from May 15-17, led by Barry Lavallee, a member of Manitoba First Nation and Métis communities and a University of Manitoba-trained family physician specializing in Indigenous health and northern practice.

“We are so pleased to have Dr. Lavallee on campus to host three sessions with staff, faculty and students,” says Leslie Flynn, Vice Dean, Education, Faculty of Health Sciences, “I know that his time here will bolster our efforts to meet our commitment to the Truth and Reconciliation Commission’s Calls to Action as they apply to healthcare and health professions education. We are engaged in a process of fostering inclusion in the Faculty of Health Sciences and hosting important conversations about Indigeneity, cultural safety and our healthcare system.”

A dynamic presenter, Dr. Lavallee speaks articulately, practically, and passionately on issues of social justice in medicine across Canada. Dr. Lavallee’s clinical work has focused on the health and healing needs of First Nation and Métis communities. He has a Masters of Clinical Sciences from the University of Western Ontario and his research and clinical areas are chronic diseases, transgenerational trauma, impact of colonization on Indigenous communities and international Indigenous health. 

“As physicians and health care providers our role in addressing reconciliation is to critically examine the role Indigenous specific racism plays as a determinant of health for Indigenous Peoples,” Dr. Lavallee says. “More specifically, what role do we play in addressing this form of racism in our profession?”

The three interactive events are:

May 15, 4 pm
Racism as an Indigenous Social Determinant of Health
Public Lecture – Britt Smith Lecture Hall, School of Medicine

May 16, 8 am
Teaching Methods for Addressing Cultural Safety: Promoting Indigenous Health
Faculty Development Workshop – University Club, George Teves Room

May 17, 8 am
Indigenizing Educational Research and Workforces in Healthcare: Struggles and a way forward
Heath Science Education Round – Richardson Laboratory, Room 104

Of special note, following Dr. Lavallee’s presentation on Wednesday, Laura Maracle, Indigenous Cultural Safety Coordinator for Four Directions Indigenous Student Centre, will lead attendees in the KAIROS blanket exercise, a participatory history lesson developed in collaboration with Indigenous Elders, knowledge keepers, and educators that fosters truth, understanding, respect and reconciliation among Indigenous and non-indigenous peoples.

This series was developed collaboratively between the Indigenous Health Education Working Group, Faculty of Health Sciences Decanal Leadership, and the Office of Professional Development and Educational Scholarship.

To learn more or to register for the programs, visit the Faculty of Health Sciences website.

Input sought on future of Faculty of Health Sciences, search for next dean

Interim Provost and Vice-Principal (Academic) Tom Harris announced today that Richard Reznick’s term as dean of the Faculty of Health Sciences, Director of the School of Medicine and CEO, Southeastern Ontario Academic Medical Organization ends on June 30, 2020.

Provost Harris will chair a committee to advise the principal on the future direction of the Faculty of Health Sciences, and on the selection of the next dean. 

“I encourage all members of the Queen’s community to provide input regarding the Faculty of Health Sciences, and to suggest individuals to serve on the advisory committee,” says Provost Harris.

Please send all submissions and advisory committee suggestions to the Office of the Provost, via e-mail, to provost@queensu.ca, by Tuesday, May 14. Respondents are asked to indicate whether they wish to have their letters shown, in confidence, to the members of the Advisory Committee.  

More information about the Faculty of Health Sciences is available in the faculty’s Strategic Planning documents, annual Dean’s Reports and the faculty website.   

Five strategies to improve medical training – to reduce stress and boost expertise

[Medical students]
Canadian medical students graduate with up to $200,000 in debt, and burnout rates are high. (Photo: Luis Melendez/Unsplash)

Recent changes in undergraduate medical education and postgraduate residency training in Canada are stressing trainee doctors, increasing their debt load and reducing their experiential learning.

Such changes include a perceived shortage of residency positions, a premature requirement to choose a career path early in medical school and a growing fixation on exam preparation.

Older doctors are largely unaware of these new challenges. For trainees, on the other hand, this is the only system they know. Patients simply expect us to produce “triple A” doctors — available, affable and able.

As a cardiologist and head of medicine at Queen’s University, I offer several suggestions to reduce trainee stress, debt and burnout. I believe these suggestions will also enhance the expertise of Canada’s newly minted doctors.

For a start, we should increase residency training positions to meet Canada’s medical needs, and simplify the Canadian Resident Matching Service (CaRMS) process for allocating residency positions. We should also constrain the time trainees spend studying for qualifying exams, delay the selection of medical career tracks until internship and restore the rotating internship.

Loss of empathy and self-worth

Nearly half of medical residents report burnout — defined as a loss of empathy and sense of self-worth. Burnout is reported ever earlier in residents, despite legislated restrictions on work hours and increased pay.

A contributing factor is the increasing time residents spend studying for the Royal College of Physicians and Surgeons of Canada (RCPSC) qualifying exams. Trainees are also impacted by funding decisions of provincial governments, which limit the size of medical schools and residency programs, and by hospital congestion, which impairs the learning environment.

The reasons medical students experience burnout are complex. They include worries about whether they will match to a residency program and about which career track to select during their second year. Students also worry about debt — the average medical school debt was over $70,000 in 2014. This number increased to over $158,000 in 2017 (and many students borrow up to $200,000).

While tuition (at around $20,000 per year) is an important source of debt, a new and avoidable expense relates to the cost of off-site electives and CaRMS interviews incurred in their search for future residency positions.

1. Increase residency positions

So, what if we increased residency positions 10 per cent while reducing off-site medical school electives?

Medical students and residency training programs rank each other through an online system, called CaRMS. Recently, the number of unmatched Canadian graduates has been increasing — from 11 in 2009 to 68 in 2017. While 68 unmatched students (from a national total of 3000) may sound like a small problem, it can have tragic consequences.

Medical school graduate Robert Chu ended his life in 2016, after twice failing to match. He wrote:

“Without a residency position, my degree … is effectively useless. My diligent studies of medical texts, careful practice of interview and examination skills with patients and my student debt in excess of $100,000 on this pursuit have all been for naught.”

Of course, we should only create more residency positions if we need more doctors. Provincial governments tend to believe there are too many doctors; however, OECD data show Canada (with two MDs per 1,000 population) ranks near the bottom of the pack.

 

In 2017, there were 2,967 residency positions available in Canada and 2,810 residents in the hunt. This scarcity is exacerbated by an influx of international medical graduates, many of whom are Canadian citizens, a net outflow of students from Quebec and fewer available positions in “popular” specialty programs, such as dermatology, emergency medicine and plastic surgery.

 

This means that there is just two per cent wiggle room between positions required and positions available, complicated by student geographic and specialty preferences.

2. Develop a ‘learn local’ strategy

To reduce the risk of being unmatched, medical students spend their time criss-crossing Canada performing electives to demonstrate their interest in a program, while serving as their own travel agent and paying for travel and accommodations.

This adds to their debt and stress and these brief sojourns often yield superficial clinical experiences. One budding dermatologist told me:

“I did six electives in dermatology (12 weeks total), and two electives in internal medicine… If I was to do it again, I probably wouldn’t have done so many dermatology electives - it’s just that I didn’t get the ones I really wanted until the end. I’m not sure I necessarily needed to do this many dermatology electives in order to match….I definitely felt the pressure to do the majority of my electives in this specialty to show my interest and build relationships at the programs I was interested in. … I can’t say exactly how much I spent. Certainly, in the thousands of dollars.”

Another student toured 12 universities across Canada to interview for surgery residencies. She ended up with her first choice of residency and stayed at her home university. Between external electives and the CaRMS interviews, medical students lose around four months of local clinical exposure.

A “learn local” strategy combined with a 10 per cent increase in residency positions would reduce expense, travel and stress and allow students to extend rotations at their own centres. The proposed changes would also right-size our medical work-force.

3. Delay specialty selection

What if we delayed the choice of career track until internship?

Some students struggle to choose a speciality. Family physician, internist, surgeon, pediatrician, obstetrician, radiologist, ophthalmologist, pathologist… there are many options. How can an informed choice be made after two years of relatively superficial exposure to the options?

A Queen’s student noted:

“It felt like there was an abrupt change when we went from exploring disciplines in medical school to when we needed to decide on our specialization. In first year, we were required to do observerships to promote variety. But midway through second year we needed to select our clerkship stream and then all of a sudden it seemed like decisions had to be made…. Midway through second year, by picking my stream, I had to decide that I was not going to pursue emergency medicine, anesthesia or a subspecialty surgery.”

By delaying specialty selection until internship, trainees could make more informed choices.

4. Reinstate the rotating internship

What if we reinstated the rotating internship?

A rotating internship gave doctors a broad experience. We abandoned the rotating internship in favour of a two-year family medicine residency in around 1990. However, rotating internships did not just train GPs, they also trained many future specialists.

During my rotating internship at Royal Columbian Hospital in New Westminster, British Columbia, from 1981 to 1982, I spent time in obstetrics (delivering more than 100 babies), pediatrics (caring for sick and premature babies), surgery (as first assist on all operations and primary surgeon for hernias and appendectomies), intensive care (placing arterial lines and managing ventilators) and internal medicine (running the ward).

I learned respect for each specialty by walking a mile in their shoes. These practical experiences alter the medical DNA of a young physician in a way no clerkship experience can. Re-establishing a rotating internship as the first year of residency would result in Canada’s doctors being more broadly trained.

5. Reduce preparation time for exams

Exams consume a trainee’s after-hours life for one month of medical school and nine months of residency, engendering stress and contributing to burnout. Studying too much may also distract trainees from clinical learning opportunities.

Objectively however, the success in the RCPSC exam has long been 95 per cent for Canadian graduates (likewise the LMCC exam for medical students).

Let’s recast medical school and residency as programs for adult learners and reset expectations for how much time a trainee can or should study to some reasonable duration — say one month for medical students and two months for residents.

The training of doctors is a joint responsibility of universities, provincial agencies, accrediting agencies and society. Together we should refocus medical school and residency training with the goal of producing triple A doctors who are more clinically experienced, less stressed and owe less money.The Conversation

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Stephen Archer is a professor and the head of the Department of Medicine at Queen's University.

This article is republished from The Conversation under a Creative Commons license. Read the original article.

The Conversation is seeking new academic contributors. Researchers wishing to write articles should contact Melinda Knox, Associate Director, Research Profile and Initiatives, at knoxm@queensu.ca.  

Understanding bleeding disorders

Women with bleeding disorders can wait up to 15 years to get appropriate testing and treatment. (Shutterstock)

About 30 per cent of all women report heavy menstrual periods at some point during their reproductive years. Up to 15 per cent of these have an underlying bleeding disorder and yet most have never been diagnosed, leaving thousands of women to suffer from a treatable problem.

As a hematologist and clinician scientist at Queen’s University who cares for patients with inherited bleeding disorders, it is a major source of frustration for me that women with bleeding disorders can wait up to 15 years to get appropriate testing and treatment.

I worry even more about what happens to those who never get diagnosed. These women are at risk of acute hemorrhages leading to blood transfusions and the need for hysterectomy.

Because April 17 is the 29th annual World Hemophilia Day — a day focused on outreach and education about hemophilia — I would like to share some evidence-based information about heavy periods, what it means to be a female “carrier” of hemophilia and how you can easily test yourself for a bleeding disorder.

Iron deficiency and abnormal periods

Bleeding disorders that affect women include von Willebrand disease and hemophilia — both are inherited and are caused by low levels of “clotting factors” (proteins needed for normal blood clotting).

In families with a bleeding disorder, it is common for women to not realize their periods are heavy because other affected women in the family have similar problems. To them, heavy periods seem normal.

There are also social stigmas against an open discussion about periods that can be difficult to overcome. And there is a lack of accurate information about normal versus abnormal periods.

Key features of heavy and abnormal periods include having to change pads or tampons more than every hour, having iron deficiency anemia, frequently soaking through your sheets at night and bleeding that lasts longer than seven days.

Iron deficiency anemia is of particular concern because it leads to fatigue and shortness of breath as well as poor school and job performance.

Iron deficiency and heavy periods are too often ignored but can be signs of an underlying bleeding disorder. Both are easily treated once the diagnosis is made.

Women can also have hemophilia

Women who are carriers of hemophilia are very often considered to be “only carriers” — capable of passing on a mutant gene to their children. They may be told this by their doctor. Their bleeding then often goes untreated because of this misconception.

My own research has shown, however, that around 30 to 40 per cent of hemophilia carriers experience abnormal bleeding including heavy periods, post-partum hemorrhage and joint bleeds. Some, but not all, have low clotting factor levels.

Effective treatments for heavy periods in women with bleeding disorders are widely available. These include the oral contraceptive pill and medications like tranexamic acid (that prevent clot breakdown) and desmopressin (that increases clotting factor levels).

Gynecologic options such as the levonorgestrel intrauterine device (IUD) and endometrial ablation also exist.

In rare cases, women with bleeding disorders require clotting factor infusions to control heavy periods. If iron deficient, iron supplementation is a key component of treatment as it improves quality of life. Dietary iron intake alone is not enough to correct iron deficiency, particularly once it has caused anemia.

Historically, much of the focus of research and education for hemophilia was on improving treatment for boys and men with the disease. The mainstay is frequent intravenous infusions of the missing clotting factor. Significant advances have been made including the development of better treatments and the possibility of cure.

Are your bleeding symptoms normal?

Many organizations are now focused on increasing public knowledge about bleeding disorders. The recognition that women can also have hemophilia is increasing through the efforts of organizations like the World Federation of Hemophilia.

Related articles
Unraveling mysteries in the blood
International research leader earns top honour
New website developed at Queen’s University helps women detect the signs and symptoms of a bleeding disorder

The role of novel therapies for women with hemophilia isn’t clear, and additional research is required to understand exactly why these women bleed. One recent study from my lab showed that the blood clotting system of hemophilia carriers doesn’t react to hemostatic stress (such as trauma) as well as it does in healthy controls. A rapid and sustained increase of blood clotting factors is required to halt bleeding following injury and this was significantly impaired in hemophilia carriers.

If you are wondering if you have a bleeding disorder, the Self-BAT (self administered bleeding assessment tool) is freely available and can tell you if your bleeding symptoms are normal or abnormal.

This tool analyzes information about your bleeding symptoms to generate a bleeding score. A high bleeding score is associated with an increased chance of having an underlying bleeding disorder and should be discussed with your doctor.

Significant advances have been made in understanding the problems faced by women with bleeding disorders. More research and education is needed so that all women are diagnosed and treated properly.The Conversation

____________________________________________________

Paula James is a professor in the Department of Medicine at Queen's University with cross-appointments to the Department of Pathology and Molecular Medicine and the Department of Pediatrics.

This article is republished from The Conversation under a Creative Commons license. Read the original article.

The Conversation is seeking new academic contributors. Researchers wishing to write articles should contact Melinda Knox, Associate Director, Research Profile and Initiatives, at knoxm@queensu.ca.  

Queen’s University moves to right historic wrong

Principal Daniel Woolf and Dean Richard Reznick formally apologize for school’s 1918 ban of Black medical students.

  • A century after banning admission of Black students to its medical school, Queen’s University has extended a formal letter of apology.
    Principal and Vice Chancellor Daniel Woolf and Dean of Health Sciences Richard Reznick sign the formal letter of apology during the meeting of Queen's University Senate on Tuesday, April 16. (University Communications)
  • Dean of Health Sciences Richard Reznick
    Dean of the Faculty of Health Sciences Richard Reznick makes a presentation after signing a formal letter of apology for the 1918 ban on admission of Black students to Queen's University's medical school. (University Communications)
  • Edward Thomas, Daniel Bartholomew
    Present at the signing ceremony was Daniel Bartholomew, centre, son of Ethelbert Bartholomew – an upper-year student whose medical career was abruptly ended by the policy in 1918. (University Communications)

A century after banning admission of Black students to its medical school, Queen’s University has extended a formal letter of apology acknowledging the institution’s past racist actions and repeated failures to hold itself accountable. In an official ceremony, Principal and Vice-Chancellor Daniel Woolf and Dean of Health Sciences Richard Reznick signed the letter and expressed profound regret on behalf of the institution for injustices enacted upon its Black medical students, alumni, and prospective applicants.

“We are resolved to confront our past actions, and to more fully understand the meaning of the university’s historical racism, including a commitment to identify its causes and consequences to the best of our ability,” reads the formal apology issued by Principal Woolf and Dean Reznick. “In reckoning with our institutional history, we are committed to acknowledging our failures and to learning from our mistakes. It is our sincere desire to confront this past, learn from it, and never again repeat it.”

In 1918, the Senate of Queen’s University voted to support a motion prohibiting students of African descent from attending its medical school, at the request of the Faculty of Medicine – a ban that went enforced until 1965. According to recent research by Queen’s PhD candidate, Edward Thomas, the ban was put in place to demonstrate alignment with discriminatory policies favoured at the time by the American Medical Association, the organization that ranked medical schools in North America.

Even after 1965, archival evidence suggests the historical facts of the ban were misrepresented by the university when confronted with the issue in 1978, 1986, and 1988. In 2018, once Mr. Thomas presented his research findings to the current Queen’s Senate and brought to light the motion’s continued existence, the university formally rescinded the resolution that enabled the ban.

“As an institution, we can never undo the harm that we caused to generations of Black students, and we have to accept that our actions contributed to the inequities in the medical profession that still exist today,” wrote Dr. Reznick in a blog post published in advance of the ceremony. “I hope, though, that our actions will continue to move the School of Medicine in the direction of greater inclusivity, diversity, and equity.”

The public apology marked the first in a series of necessary steps identified by a commission of Queen’s faculty, students, and staff formed by Dean Reznick to address this historic injustice. Family members of individuals affected by the ban will receive personal letters of apology, and the School of Medicine will soon house an exhibit addressing the ban and its impacts. Course curricula will place greater focus on diversity, equity, and inclusivity, and a symposium examining the past, present, and future of the Black medical student experience is being organized for Winter 2020.

The School of Medicine established a mentorship program in March 2019, through which Black faculty members have volunteered to serve as mentors to Black medical students enrolled at Queen’s as they progress through clerkship, residency, and into the medical profession. The school has also created an admissions award for Black Canadian students entering into the first year of undergraduate medical education. Recipients will be awarded up to $10,000, based on academic achievement and demonstrated financial need.

“The Faculty of Health Sciences has shown great leadership in righting this historical wrong, and I look forward to seeing the implementation of its new programs to support Black student success and diversity in the medical profession,” says Stephanie Simpson, Queen’s Associate Vice-Principal (Human Rights, Equity, and Inclusion). “We owe much to the staff, faculty, students, and alumni who work tirelessly to ensure that this campus is a place where everyone feels welcomed, valued and respected, and able to participate without discrimination.”

For more detail on this matter and on the university’s future steps, read Dean Reznick’s blog post in full.

An ‘innovative and collaborative’ educator

Throughout her career at Queen’s University Heather Murray, an associate professor in the Department of Emergency Medicine, has won a number of teaching awards.

[Heather Murray]
Heather Murray (Emergency Medicine) is the winner of the 2019 Chancellor A. Charles Baillie Teaching Award.

Described by her colleagues as a “passionate, dedicated, innovative and collaborative,” educator it is perhaps no surprise that Dr. Murray is this year’s recipient of the Chancellor A. Charles Baillie Teaching Award, which recognizes undergraduate, graduate or professional teaching that has had an outstanding influence on the quality of student learning at Queen’s.

While Dr. Murray is honoured to receive the award, she is quick to highlight that many fellow faculty and staff members have contributed to her teaching achievements.

“I'm thrilled to be included in the list of stellar educators at Queen’s who have been recognized with this award – it's a huge honour,” Dr. Murray says. “At the same time, I recognize that it takes the collective work of a team to deliver excellent teaching. I'm able to create high quality learning events because of a large amount of background effort from both the Department of Emergency Medicine and the Undergraduate School of Medicine. The environment in my department and at the medical school encourages innovation and excellence. I'm fortunate to work here. It is clear that the learning experience of students is paramount.”

As a faculty member, Dr. Murray has been heavily engaged in teaching, curriculum development and leadership within the Undergraduate Medical Education program at the School of Medicine and has played a significant role in almost every aspect of the curriculum.

This hasn’t gone unnoticed.

“The adjudication committee was particularly impressed with the energy and imagination Dr. Murray brings to educational innovations and her fearless and relentless approach to improving student learning through educational change,” says Jill Scott, Vice-Provost (Teaching and Learning). “Dr. Murray is an exemplar for scholarly approaches to educational leadership with her tireless efforts to include clinical reasoning into the medical school curriculum.”

In winning the award several achievements were highlighted.

The first was the development, implementation and evaluation of a new curriculum enhancing the medical student learning of evidence-based medicine (EBM) and critical appraisal of scientific literature. The curriculum has had a lasting impact on student confidence and ability to interpret and apply emerging medical science long after they have graduated from Queen’s.

Chancellor A. Charles Baillie Teaching Award recipients:
2018 Erik Knutsen, Faculty of Law
2017 Catherine Donnelly, School of Rehabilitation Therapy
2016 Jill Atkinson, Department of Psychology
2015 James Fraser, Physics, Physics Engineering and Astronomy
2014 Stephen Lougheed, Biology
2013 Anne Godlewska, Geography
2012 Lindsay Davidson, Surgery
2011 Brian Frank, Electrical and Computer Engineering
2010 Mark Weisberg, Law
2009 Richard Ascough, Theology/Religious Studies
2008 Bill Newstead, Chemistry
2007 Ron Easteal, Anatomy and Cell Biology
2006 John Smol, Biology

For this work, Dr. Murray was recognized with the inaugural Principal’s Education Award for Curriculum Development.

With the support of a number of Emergency Medicine colleagues Dr. Murray also created a series of Diagnostic Reasoning teaching sessions embedded in the second-year Clinical Skills course. Beyond the lessons, this intervention displayed a vision to realign the clinical skills teaching activities of physicians with educational encounters that are authentic to their clinical practice experience, enhancing the impact of the experience for both student and faculty.

She also designed a new course in the second year of Medical School (Case of the Month) which uses patient illness stories to not only teach fundamental clinical knowledge, but also incorporate complex elements such as legal issues, professionalism, and complex communication.

Dr. Murray says that she works hard to ensure her students understand what she is teaching and, when complete, they will have an appreciation of how these challenging concepts apply to the practice of medicine on a practical level.

“The volume of information medical students receive and are expected to understand is daunting; creating relevance by drawing a line between content and the real world applications is really important,” she says. “I strive to make my learning events engaging. Although I love adding humour whenever possible, more often engagement means adding patient perspectives to the content. At the end of the day, I want my students to become excellent physicians incorporating the best possible evidence while sharing care decisions with their patients. Everything I do works towards that goal.”

Dr. Murray will be recognized during Spring Convocation and will be the featured speaker at the annual teaching awards ceremony in January 2020.

More information about the Chancellor A. Charles Baillie Teaching Award, including eligibility requirements, is available on the Centre for Teaching and Learning website.

Making Health Sciences more inclusive for Indigenous students

Indigenous Access and Recruitment Coordinator Cortney Clark is helping Indigenous students find their way into health sciences programs, navigate the university, and thrive in their time at Queen’s.
Cortney Clark is the Indigenous Access and Recruitment Coordinator for the Faculty of Health Sciences at Queen's University.

This article was first published on the Faculty of Health Sciences Dean’s Blog.

Last year, the Faculty of Health Sciences welcomed Cortney Clark as the new Indigenous Access and Recruitment Coordinator. In this role, Cortney is doing the very important work of helping Indigenous students find their way into health sciences programs, navigate the university once they’ve arrived and ultimately thrive in their time here at Queen’s. 

A Mohawk woman and member of the Bear Clan of the Wahta Mohawk Territory in northern Ontario, Cortney knows very well that Indigenous people in Canada face obstacles to resources, like higher education, that many settler Canadians never experience.

“This work feels personal for me,” Cortney says. “I understand the need for this work and I want to use my lived experiences and abilities to help propel reconciliation through accessible and culturally safe higher education.”

She first started working to build connections with Indigenous communities as a recruitment coordinator for the Aboriginal Post-Secondary Information Program (APSIP).

Through APSIP, Cortney travelled widely to more than 55 different Indigenous communities, many of them in remote and rural locations in northern Ontario. In these different communities, she advised learners on Indigenous access policies to higher education, and specifically advised on the application and admissions processes for Canadian universities and colleges.

While she found it rewarding to help so many people in so many different areas, Cortney has been particularly excited to be able to provide “wraparound service” to the community of health sciences students at Queen’s in her new role. Wraparound service means that she works with Indigenous students from the beginning of their application process through to their graduation.

Cortney advises prospective students on their applications to the Faculty of Health Sciences; she works to create a culturally safe community for students when they arrive; and she helps connect them with career development resources tailored to their needs. She is also available to help students with anything else that arises during their time at Queen’s. All the students that she works with have her cell phone number, and they know that she will answer if they call.

On top of her recruitment, advising, and student support programming portfolio, Cortney is also an active member in a number of different committees in the Faculty of Health Sciences that are advancing our TRC initiatives. For instance, Cortney is a part of the faculty’s Indigenous Health Education Working Group (IHEWG), which is comprised of faculty members and students from each of our three schools.

IHEWG works to build connections with Indigenous communities to find out how Queen’s can help them achieve better health outcomes. The working group is also developing a range of initiatives to ensure that Queen’s trains health practitioners to deliver culturally safe care for Indigenous patients, who frequently encounter racism and insensitivity in the Canadian health care system.

To work towards this goal, the IHEWG, along with the Office of Professional Development and Educational Scholarship, has organized an important series of events with Barry Lavallee, a professor at the University of Manitoba, a practicing family physician, and an expert on Indigenous health. Dr. Lavallee will be visiting May 15-17. He will provide training on working with Indigenous communities and also give a public lecture on how racism affects Indigenous health.

The IHEWG also recently led the hiring of Tim Yearington, the new Indigenous Curricular Innovation Coordinator in FHS. Tim will take a key role in decolonizing our health sciences curriculum and ensuring that Indigenous knowledge as well as the perspectives of our Indigenous students, health professionals and patients are reflected in our programs.

Cortney is also working to help integrate services for Indigenous students across Queen’s by serving as an active member of the Community of Practice Working Group. This group is chaired by Kandice Baptiste, Director of the Four Directions Indigenous Student Centre, and it aims to connect all the Indigenous staff and leadership who work closely with Indigenous policy and Indigenous students at Queen’s.

As you can see, Cortney has already been very busy since starting her new role at the faculty in August. And she is planning a lot of projects for the coming months. Just over March break, she did recruitment work at the Little Native Hockey League in Mississauga, where she spoke to over 227 hockey teams of Indigenous students and their parents about post-secondary programs at Queen’s.

She is also hosting, in partnership with Four Directions, an academic recruitment fair for prospective Indigenous graduate students on May 4, at Queen’s. Universities from across Canada, including Trent, McGill, Concordia, Toronto and Lakehead, just to mention a few, will be participating in what promises to be an important event for helping Indigenous students realize the different research opportunities and programs in graduate-level education.

I am very grateful for all the work that Cortney has been doing to help the faculty work towards its goals for responding to the TRC report, and I know that the rest of my colleagues on the decanal team are as well.

Dean Reznick thanks Andrew Willson for his assistance in preparing this blog.

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