Jewish General Hospital Virtual Medical Grand Rounds

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:

  1. Counsel patients on the risk of serious anticoagulant-related bleeding
  2. Apply best practices to restarting anticoagulation after gastrointestinal and intracranial bleeding
  3. 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:

  1. To review the management of pleural infections
  2. To discuss our in-hospital pleural infection protocol 
  3. 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:

  1. Be aware of how the ground is shifting with regards to genetic testing for cancer susceptibility
  2. 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:

  1. To define the nature of social capital as an attribute of health care organizations seeking to improve the value of their care
  2. To define the importance of “currencies” of social capital, including trust, alignment, and respect.
  3. 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:

  1. Understand financing challenges and different funding models in our healthcare system
  2. Review processes that were used to evaluate current costing estimates and performance
  3. 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:

  1. Appreciate that prognosticating EARLY is fundamental to providing excellent medical/surgical care in advanced disease
  2. Promote the use of objective tools to break through the emotional barrier of predicting a patients’ death
  3. 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:

  1. Describe the course of natural infection by HPV
  2. 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
  3. Describe the novel HPV detection tests in 2024 and how results will be reported
  4. 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:  

  1. Understand the principles and values of peer-mentorship.
  2. Acquire tools to engage, train, and mobilize volunteers in a peer-mentoring relationship with NICU families.
  3. 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

  1. To review some causes and consequences of right heart failure
  2. To discuss options and efficacy of percutaneous valve-in-valve therapy and discuss a case where this was employed successfully
  3. 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:  

  1. Secondary central nervous system lymphoma (SCNSL) is an uncommon presentation in diffuse large B‐Cell lymphoma (DLBCL).
  2. Patients with a CD4 count below 200 and neurological symptoms warrant a gadolinium‐enhanced MRI scan.
  3. 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:

  1. To reinforce the importance of the goals of care conversations, and the completion of the LOI forms
  2. To support a better understanding of the ethical, legal, risk management, and medical perspectives of this important process
  3. 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:

  1. To explain how evidence-based medicine differs in clinical and nutritional pharmacology
  2. To tackle the hospital’s epidemic of iron deficiency
  3. What happened to plasma homocysteine? Current status
  4. What happened to vitamin D? Current status
  5. 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:  

  1. 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 
  2. Have a better understanding of the RQDM strategic planning for molecular diagnostics in oncology and what tests will be made achievable in 2024 
  3. 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:  

  1. To review the evolving clinical and paraclinical spectrum of autoimmune encephalitides 
  2. 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:  

  1. To review the diagnostic criteria of polycystic ovarian syndrome 
  2. To screen for appropriate conditions associated with polycystic ovarian syndrome 
  3. 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:  

  1. Discuss how to classify and assess risk in acute PE  
  2. Discuss the medical therapy and ICU management of high-risk PE  
  3. 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:  

  1. Provide a sense of community 
  2. Give voice to health care professionals 
  3. 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: 

  1. To understand the legal and ethical obligations concerning disclosure of incidents and accidents in healthcare.    
  2. To increase awareness of the CCOMTL policy and procedure on disclosure.    
  3. 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:  

  1. Identify cutaneous manifestations of selected infectious/tropical diseases  
  2. Generate differential diagnoses for selected cutaneous clinical presentations  
  3. 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:  

  1. To describe the importance of dietary patterns in older adults
  2. To identify the key dietary patterns that may inform frailty prevention
  3. 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:  

  1. Discuss literature surrounding emerging treatable traits in COPD, namely chronic hypercarbic respiratory failure and frailty.
  2. 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:  

  1. Review current knowledge regarding duration of infectivity of individuals with COVID-19
  2. 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:  

  1. Define virtual care and its components  
  2. Review the evidence for Hospital at Home as a care paradigm in the literature and within our CIUSSS 
  3. Discuss challenges, controversies and opportunities around providing care outside of the traditional hospital setting  
  4. 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

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