JEWISH GENERAL HOSPITAL
DEPARTMENT OF MEDICINE
MONDAY MEDICAL GRAND ROUNDS
12:30 - 1:30 PM
Join the virtual Medical Grand Rounds on Microsoft Teams meeting.
Or call in (audio only) NEW: +1 438-799-0762, 502095193# Canada, Montreal, Phone Conference ID: 502 095 193#
Hybrid Medical Grand Rounds are additionally in person at the Block amphitheatre, room B-106
The Medical Grand Rounds are an accredited group learning activity as defined by the Maintenance of Certification Program of the Royal College of Physicians and Surgeons of Canada.
Some Rounds were video recorded.
Medical Grand Rounds 2023-2024
March 25
We talk to patients about death, but who talks to us?
See the poster.
Dr. Jean Zigby, MD, CCFP(PC)
Chief, Palliative Care Unit, Jewish General Hospital
Faculty Lecturer, McGill University Faculty of Medicine
Director, Division of Supportive and Palliative Care, CIUSSS CCOMTL
Vivian Myron, MSW, TSP
Social Worker, Palliative Care Services, Jewish General Hospital
Co-chair, Accreditation Canada, Palliative Care CIUSSS Centre Ouest
Dr. Beth-Ann Cummings, MDCM, MSc (HPE), FRCPC
Associate Professor, Department of Medicine, McGill University
Associate Member, Institute of Health Sciences Education
Division of General Internal Medicine, Jewish General Hospital
March 18
DVT Awareness Month
Restarting Anticoagulants After Bleeding: Whether, When, How
Dr. Deborah Siegal MD MSc FRCPC (she | her)
Hematologist (Thrombosis), The Ottawa Hospital
Associate Professor, Department of Medicine, University of Ottawa
Associate Scientist, Clinical Epidemiology Program, Ottawa Hospital Research Institute
Tier 2 Canada Research Chair in Anticoagulant Management of Cardiovascular Disease
Educational Objectives:
At the end of this presentation participants will be able to:
- Counsel patients on the risk of serious anticoagulant-related bleeding
- Apply best practices to restarting anticoagulation after gastrointestinal and intracranial bleeding
- Apply principles of shared decision-making with patients/caregivers and other health providers to optimize management for individual patients
March 11
Update on the management of pleural infections
Lama Sakr, MD
Department of Medicine, McGill University
Division of Pulmonary Diseases, Jewish General Hospital
Educational Objectives:
- To review the management of pleural infections
- To discuss our in-hospital pleural infection protocol
- To promote collaboration and expertise sharing among different specialties, in order to ensure optimal patient care
March 4
Virtual only Medical Grand Round
Universal Genetic Testing for Breast Cancer Susceptibility: From Good to GREAT
Stephanie Wong, MDCM MPH
Department of Surgery, McGill University
High Risk Breast Clinic,
Cancer Prevention Centre,
Segal Cancer Centre, JGH
William Foulkes, MBBS PhD
Division of Medical Genetics,
Department of Specialized Medicine & Cancer Genetics Service,
Cancer Prevention Centre,
Segal Cancer Centre, JGH
Educational Objectives:
- Be aware of how the ground is shifting with regards to genetic testing for cancer susceptibility
- Learn how collaboration between geneticists and other health care professionals is required to effect this change
February 26
Social Capital: The Core of Health Care Strategy
Thomas H. Lee, MD
Chief Medical Officer, Press Ganey
Senior Physician, Brigham and Women’s Hospital, Boston, MS
Educational Objectives:
- To define the nature of social capital as an attribute of health care organizations seeking to improve the value of their care
- To define the importance of “currencies” of social capital, including trust, alignment, and respect.
- To describe the use of rituals as a way of creating social norms that help build social capital
February 19
Financing Around the Patient's Trajectory - From Why to What to How - The Azrieli Heart Center Experience
Carrie Bogante CPA
Director of Finance, CCOMTL
Nadira Ramrup RN BScN
Nurse Manager, Azrieli Heart Center
Annabel Chen-Tournoux MD
Associate Professor of Medicine, McGill University
Medical Director, CVICU and Cardiology CTU, JGH
Lawrence Rudski MD FRCPC
Professor of Medicine, McGill University
Director, Azrieli Heart Center
Educational Objectives:
- Understand financing challenges and different funding models in our healthcare system
- Review processes that were used to evaluate current costing estimates and performance
- Illustrate strategies that can be implemented to augment value into our care
February 12
End of Life Prognostication: The Key to the Palliative Treasure Chest
(How to get it approximately RIGHT & not exactly WRONG)
Jean Zigby MDCM, CCFP, FCFP, (CAC)
Director of the Division of Supportive and Palliative Care, CIUSSS CODIM
Chief, Palliative Care Unit, Jewish General Hospital
Educational Objectives:
- Appreciate that prognosticating EARLY is fundamental to providing excellent medical/surgical care in advanced disease
- Promote the use of objective tools to break through the emotional barrier of predicting a patients’ death
- Clarify what Supportive and Palliative Care can offer with an appropriate prognosis in hand.
February 5
Discussion of the Recommendation of INESSS for Cervical Cancer Screening Using HPV Testing
Francois Coutlée, MD
Professor of Medicine, Université de Montréal, CHUM
Educational Objectives:
- Describe the course of natural infection by HPV
- Discuss the recommendation of the INESSs for screening cancer of the uterine cervix with HPV testing considering
- the epidemiology of HPV infection in North America
- the molecular epidemiology of HPV infection
- Results of clinical trials in Canada
- Describe the novel HPV detection tests in 2024 and how results will be reported
- Compare various markers for the triage of HPV positive samples.
January 29
Hybrid Annual Humanization of Care Awareness Program Rounds
The Peer Mentoring Projects - (The Hope & Cope / NICU Peer to Peer Mentoring Project)
Suzanne O'Brien, Chair, Board of Directors, Hope & Cope, JGH
Educational Objectives:
- Understand the principles and values of peer-mentorship.
- Acquire tools to engage, train, and mobilize volunteers in a peer-mentoring relationship with NICU families.
- Grasp the challenges involved in ensuring the sustainability of compassionate community-based programs.
Contact Person: Krystle Lee North & Susan Lavy, (Betsy Bobo, Administrative Coordinator, x 21924)
January 22
Hybrid Medical Grand Rounds – Residents Case Presentation
I. Mechanical Problems Require Mechanical Solutions: Collaboration across Sites – Fixing the Left Heart to Save the Right
Jack Rudski, MD, C.M., PGY-2, Internal Medicine, McGill University
Educational Objectives
- To review some causes and consequences of right heart failure
- To discuss options and efficacy of percutaneous valve-in-valve therapy and discuss a case where this was employed successfully
- To foster collaboration and expertise-sharing between sites
II. Cauda Equina Syndrome in a Patient with Human Immunodeficiency Virus & Secondary Central Nervous System Lymphoma
Mohammed Redha, MD, C.M., PGY-2, Internal Medicine, McGill University
Educational Objectives:
- Secondary central nervous system lymphoma (SCNSL) is an uncommon presentation in diffuse large B‐Cell lymphoma (DLBCL).
- Patients with a CD4 count below 200 and neurological symptoms warrant a gadolinium‐enhanced MRI scan.
- R‐CHOP chemotherapy and high dose methotrexate have been shown to have mortality benefit with SCNSL.
Contact Person: Samuel Mamane, MD, JGH Site Program Director Core Internal Medicine Residency at McGill University, Ext 24974
January 15
Hybrid Medical Grand Rounds
The Complicated Goals of Care Conversation – The Ethical, Medical, Legal & Risk Management Perspectives: A Patient Centered Tool
Kevin Hayes, Clinical Ethicist
Paul Warshawsky, MD, FRCPC, Chief, Intensive Care Unit; Assistant Professor, Departments of Critical Care Medicine & Medicine, McGill University
Andréane Baribeau, Lawyer, Montreal West-Central CIUSSS
Anneliese Papaurelis, SAC Quality Risk Management & User Experience
Educational objectives:
- To reinforce the importance of the goals of care conversations, and the completion of the LOI forms
- To support a better understanding of the ethical, legal, risk management, and medical perspectives of this important process
- To support the implementation & understanding of the newly revised goals of treatment policy in place, & the use of the new LOI form introduced by the INESSS
Contact Person: Kevin Hayes, MSc, Clinical Ethicist, Quality, Evaluation, Performance & Ethics – tel: 514-340-8222, ext. 23625
January 8
Hybrid Medical Grand Rounds
Nutritional Pharmacology 2024: Insights, Updates & Clinical Pearls
Leonard John Hoffer, MD, PhD, FRCPC
Division of General Internal Medicine and Nutrition Support Team
Educational objectives:
- To explain how evidence-based medicine differs in clinical and nutritional pharmacology
- To tackle the hospital’s epidemic of iron deficiency
- What happened to plasma homocysteine? Current status
- What happened to vitamin D? Current status
- To prescribe a multivitamin for starving people
Contact Person: Rubin Becker, MD, Chief, Division of Internal Medicine, Tel. 514-340-8222 ext. 24974
December 25
No Rounds – Christmas Day
Wishing you a joyful holiday season! Medical Grand Rounds will resume on January 8, 2023.
December 18
Hybrid Medical Grand Rounds
The Cancer clinical committee of the Quebec molecular diagnostic network (RQDM): activities and update
Alan Spatz, MD
Chief, Department of Clinical Laboratory Medicine, McGill University Health Center
Medical director, Optilab-MUHC network
Professor, Departments of Pathology and Oncology, McGill University
Molecular Pathology Center and X lab, Lady Davis Institute/Jewish General Hospital
Educational Objectives:
- Have a precise knowledge of what has been achieved so far by the RQDM for the Quebec population in terms of molecular diagnostics of cancer
- Have a better understanding of the RQDM strategic planning for molecular diagnostics in oncology and what tests will be made achievable in 2024
- Have a better understanding of the current challenges we face in Quebec for molecular genetics in oncology.
Contact Person: Maureen Besley, Div. of Pathology, Tel. 514-340-8274
December 11
Hybrid Medical Grand Rounds
Brain on Fire, an Update on Autoimmune Encephalitis
Hayet Boudjani, MD
Educational Objectives:
- To review the evolving clinical and paraclinical spectrum of autoimmune encephalitides
- To review what’s new in the diagnosis and treatment of autoimmune encephalitides
Contact Person: Jeffrey Minuk, MD, Chief, Division of Neurology, Tel. 514-340-8222 ext. 28770
December 4
Hybrid Medical Grand Rounds
Polycystic Ovarian Syndrome: The Complex Interaction Between Reproductive & Cardiometabolic Health
Jill Pancer, MD
Assistant Professor, Department of Medicine, McGill University
Staff Physician, Division of Endocrinology, Jewish General Hospital
Educational Objectives:
- To review the diagnostic criteria of polycystic ovarian syndrome
- To screen for appropriate conditions associated with polycystic ovarian syndrome
- To outline an initial management plan for women with polycystic ovarian syndrome
Contact Person: Mark Trifiro, MD, Chief, Division of Endocrinology, Tel. 514-340-8222 ext. 23976
November 27
Hybrid Medical Grand Rounds
Contemporary (and Controversial?) Management of Pulmonary Embolism
Jed Lipes, MD, FRCPC
Medical director, Jewish General Hospital ECMO program
Division of Critical Care Medicine, Jewish General Hospital
Division of Internal Medicine, Jewish General Hospital
Assistant Professor of Medicine, McGill University
Ali O. Abualsaud, MD, FRCPC
Interventional cardiology and adult congenital heart disease
Director, Pulmonary Vascular Interventions, Jewish General Hospital
Division of Cardiology, Jewish General Hospital
Assistant Professor of Medicine, McGill University
Learning objectives:
- Discuss how to classify and assess risk in acute PE
- Discuss the medical therapy and ICU management of high-risk PE
- Understand the role of novel catheter-based reperfusion therapy in PE
Contact: Jed Lipes, MD, Intensive Care Unit, 514-340-8222 ext. 27500
November 20
Virtual Schwartz Rounds : Zoom link to join the conference
Triaging Chaos in the ER: Cultivating Compassion Under Pressure
Patricia Dobkin, PhD, OPQ
Associate Professor, Department of Medicine, McGill University
Faculty member, McGill Programs in Whole Person Care
Psychologist, Certified Mindfulness-Based Stress Reduction Teacher
Mark Smilovitch, MD, FRCPC
Associate Professor, Department of Medicine, McGill University
Cardiology Division, Royal Victoria Hospital, McGill University Health Centre
Faculty member, McGill Programs in Whole Person Care
Educational Objectives:
- Provide a sense of community
- Give voice to health care professionals
- Normalize compassion for oneself and others
Panelists:
Shannon Fraser, MD - General Surgeon (in charge of flow issues) (in case of emergency: Maral Koolian, MD)
Maya Vardy, RN who has also been a unit agent in the ER and can bring both perspectives
Mark Buch, MD
Contact: Natalie Dayan, MD, MSc FRCPC, Associate Professor of Medicine & Associate Chair of Wellness, Dept of Medicine, McGill University – Tel. 514-934-1934 ext 76125
November 13
Virtual Medical Grand Rounds
Shifting Paradigms in the Flow Cytometric Identification of T-cell Malignancies
Pedro Horna, MD
Hematopathologist
Associate Professor
Mayo Clinic, Rochester, MN
Educational Objectives:
1. Describe contemporary and emerging strategies for the accurate identification of T-cell neoplasm by flow cytometry.
2. Recognize the high prevalence and immunophenotypic characteristics of T-cell clones of uncertain significance.
Contact: Hans Knecht, MD, Chief, Division of Hematology, Tel 514-340-8222 ext. 28799
November 6
Hybrid Medical Grand Rounds
Quality & Risk Management Program
Disclosure of User/Patient Safety Incidents
Demitra Agiomavritis, Lawyer (LL.B.), CIUSSS West-Central Montreal (CCOMTL)
Kevin Hayes, Clinical Ethicist, CCOMTL
Melody Lee, RN, MScA, Senior Advisor in Risk Management, CCOMTL
Suzanne Levitz, MD, Associate Director of Professional Services, CCOMTL
Educational Objectives:
- To understand the legal and ethical obligations concerning disclosure of incidents and accidents in healthcare.
- To increase awareness of the CCOMTL policy and procedure on disclosure.
- To understand the disclosure process using clinical examples of when disclosure is necessary.
Contact: Maude Beaupré, Associate Director of Quality, Transformation, Evaluation, Value, Clinical & Organizational Ethics and Virtual Care – 514-340-8222 ext 27895
October 30
Hybrid Medical Grand Rounds
Tropical and International Dermatology: Insights for Internists
Rachel Bierbrier BHSc, MD, MSc, DTMH
Educational Objectives:
- Identify cutaneous manifestations of selected infectious/tropical diseases
- Generate differential diagnoses for selected cutaneous clinical presentations
- Appropriately diagnose selected dermatoses in skin of colour
Contact Person: Robin Billick, MD, Chief, Division of Dermatology, Tel. 514-340-8272
October 23
Hybrid Medical Grand Rounds
Nutrition for Frailty Prevention: Bridging the Distance Between Science and your Dinner Plate
Marian T. Hannan, DSc, MPH
Professor of Medicine, Harvard Medical School and Senior Scientist, Hebrew SeniorLife, Boston MA
Educational Objectives:
- To describe the importance of dietary patterns in older adults
- To identify the key dietary patterns that may inform frailty prevention
- To effectively use information from current studies in strategies to inform research and clinical communications with older adults in the community
Contact Person: Ruby Friedman, MD, Interim Chief, Division of Geriatric Medicine, Tel. 514-340-7501
October 16
Hybrid Medical Grand Rounds
A COPD Update: Beyond Puffers and Cigarettes
Mathew Cherian, MD
Division of Pulmonary Medicine, Jewish General Hospital
Assistant Professor of Medicine, McGill University
Educational Objectives:
- Discuss literature surrounding emerging treatable traits in COPD, namely chronic hypercarbic respiratory failure and frailty.
- Discuss new literature regarding the pathogenesis of COPD and emerging avenues for possible intervention.
Contact Person: Jason Agulnik, MD, Chief, Division of Pulmonary Medicine, Tel. 514-340-8205
October 9
No Rounds – Thanksgiving Day
October 2
Hybrid Medical Grand Rounds
Ninth Annual JGH Department of Medicine Clinical Research Symposium
Simple Question, Complex Answer. Determining the Duration of Contagiousness of Individuals with COVID-19.
Yves Longtin, MD
Chair, Infection Prevention & Control Unit,
Division of Infectious Diseases, Jewish General Hospital
Associate Professor of Medicine, McGill University
Educational Objectives:
- Review current knowledge regarding duration of infectivity of individuals with COVID-19
- Identify current knowledge gaps that influences current recommendations
Contact Person: Vicky Tagalakis, MD, FRCPC MSc, Physician-in-Chief, Jewish General Hospital
Associate Chair, Department of Medicine, McGill University. Tel: 514-340-7538
September 25
No Rounds – Yom Kippur
September 18
Virtual Care - Challenging our Traditional Values in the Provision of Value Based Care
I. Lawrence Rudski MD FRCPC FACC FASE
Professor of Medicine, McGill University
Director, Division of Cardiology
Director, Azrieli Heart Centre
Medical Director, Virtual Care, Jewish General Hospital
II. Erin Cook, MSN
Director of Quality, Transformation, Evaluation, Value, Clinical & Organizational Ethics, and Virtual Care
Educational Objectives:
- Define virtual care and its components
- Review the evidence for Hospital at Home as a care paradigm in the literature and within our CIUSSS
- Discuss challenges, controversies and opportunities around providing care outside of the traditional hospital setting
- Provide future directions for VC as a vehicle to improve patient centered and value based care
Contact Person: Lawrence Rudski MD FRCPC FACC FASE, Professor of Medicine, McGill University, Director, Division of Cardiology - Tel. 514-340-8222 ext. 22992
September 11
SPECIAL EVENT FOR INTERNAL MEDICINE RESIDENTS & PHYSICIANS IN THE DEPARTMENT OF MEDICINE
Residents’ Welcome Reception
Carrefour Lea Polansky, Pavilion K
Contact Person: Vicky Tagalakis, MD FRCPC MSc, Physician-in-Chief, Jewish General Hospital
Associate Chair, Department of Medicine, McGill University. Tel: 514-340-7538
September 4
No Rounds – Labor Day