Author Archives: CMAJ

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This article is co-authored** by (top row) Christina M. Nowik , Pamela Lai, , , (bottom row) Gillian Shiau, , , and Jasmin Yee, all of whom previously served on the Resident Doctors of Canada () Resiliency Working Group


For Canadian resident doctors, July 1st is more than a national holiday; it represents the day when newly-minted doctors become responsible for decisions in patient care.  While this is an exciting day, it can also be fraught with anxiety and stress. Over the course of residency, acute work-related stressors, including traumas and patient deaths, can negatively impact residents’ wellbeing.  Additionally, residents endure chronic stressors such as large debts, extended work  hours, and isolation from family.  These factors predispose residents to burnout. The is up to a staggering 75%. Resiliency interventions have been shown to work, and the time to begin implementing them nationwide is now. ...continue reading

is Deputy Editor at CMAJ


Rising awareness of the toll that is taking on our profession and our healthcare services has inspired numerous organizational physician wellness initiatives and resilience courses aimed at individual physicians. Yet, as experts discuss the of the system-level approach vs. the individual-wellness-training approach to addressing burnout, one key element seems to be all-but ignored: the healing power of the relationship between physicians and the patients they serve.

Dr. Tom Hutchinson, in his book, Whole Person Care: Transforming Healthcare (Springer International Publishing AG, 2017), suggests that we have lost touch with “the interior processes of healing and growth in the individual patient and the practitioner that give meaning to illness and to healthcare,” ...continue reading

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Reza Mirza is a second year Internal Medicine resident at McMaster University

Justin Hall is a third year Emergency Medicine Resident at the University of Toronto.

Odion Kalaci is a PGY-3 in Pediatrics at the University of British Columbia

(All authors are members of the Practice Committee of the Resident Doctors of Canada - )


In Canada, 38 percent of recently graduated specialists are unemployed or underemployed with a further 31 percent having delayed entering the job market altogether according to . Thus, many of us will struggle. As residents and members of Resident Doctors of Canada (RDoC), this report is alarming as it reinforces existing job-security anxieties. And yet Canadian patients face the longest wait times among high income countries. Consider: 29 percent of patients had to wait four or more hours for an emergency room visit, compared to one to four percent in Germany and France according to a Commonwealth Fund .

Specifically, the report reveals that 16 percent of specialist physicians were unable to secure employment three months from certification. This excludes 22 percent of new physician graduates who piece together an income by combining locum and part-time positions (they wryly self-identify as “locum-ologists”) ...continue reading

  is the chief resident in the Department of Physical Medicine & Rehabilitation at Western University

is a fellow in cardiovascular disease at Northwestern University Feinberg School of Medicine


The meteoric rise of bitcoin has fueled and, more broadly, blockchain technology. The once obscure brainchild of has evolved into a speculator’s paradise, rivaling the . While bitcoin’s future as a digital currency is a topic of debate, its underlying blockchain software has become the foundation for a technological revolution that began in finance, but is . The application of blockchain to the world of healthcare may prove to be its most humanitarian of functions.

Acclaimed as one of the biggest innovations since the internet itself, blockchain eliminates trusted third parties such as banks from online transactions and replaces them with a decentralized database, or a ledger, of transactions. The ledger is stored across a network of computers that is visible to everybody, and a combination of cryptographic keys is used to create a secure reference of identity. ...continue reading

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Sharon Yeung is a MD/MSc student at Queen’s University


I’ll be the first to admit: I’ve never been one for politics.

The garish lawn signs of electoral campaigns, the predatory advertisements and the shiny, charismatic politicians, bred in me a deep political apathy at an early age. It was an apathy fueled by a lack of understanding of how these matters were relevant to my daily life – and for the most part, my political apathy was left unchallenged.

I suspect my experiences are not unlike those of my peers in my generation. After all, weren’t we all once taught that politics is a sacred taboo? The kind you should never talk about at dinner, second only to religion. As it turns out, it’s also the kind you don’t talk about in polished Medical School Classrooms.

The apolitical culture of medical school is, however, not inconsequential. ...continue reading


Sarah Tulk is an Ontario physician who recently finished her residency training in family medicine at McMaster University


“If only he had chosen a higher floor, we wouldn’t have had to come here!”

These were the words that came out of my preceptor’s mouth. I was a wide-eyed medical student, shadowing in orthopedic surgery. The patient was an older man who had sustained multiple fractures after attempting to end his life by jumping from an apartment building balcony. The trauma ward was full, so he was, inconveniently, located on a distant ward which meant his poor choice of departure level was now encroaching on our operating room time. In medical school, I learned that mental illness was shameful before I learned how to use a stethoscope. ...continue reading

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is a medical student at McMaster University

is an emergency medicine resident at McMaster University and a freelance journalist


Bandar Baw is an assistant professor, emergency physician and toxicologist at McMaster University



The early part of 2018 has seen the rise of the “Tide Pod Challenge”, in which people have posted viral videos of themselves attempting to eat laundry detergent pods from a variety of brands. The number of for laundry detergent pod poisoning in the first 15 days of 2018 already equalled all calls in 2017, thanks to internet viral videos. These ingestions pose a significant concern for the healthcare system, as care spans a variety of disciplines and is a presentation that many may not be familiar with. ...continue reading


Mehdi Aloosh is a Public Health and Preventive Medicine resident (R1) at McMaster University and a graduate of medicine from Tehran University and master’s in surgical education from McGill University


Cal Robinson is a pediatric resident (R1) at McMaster University and completed medical school in the UK


International Medical Graduates (IMGs) that match to residency positions in Ontario are required to participate in the Pre-Residency Program (PRP) in order to begin their residency.  We participated in the 2017 PRP program as trainees and benefited from the learning opportunities specific to practicing medicine in Canada that the program provided. However, the PRP program structure does not follow the fundamental principles of Competency-Based Medical Education (CBME). PRP re-design, incorporating a CBME model of outcome-based assessment with identification of residents requiring additional support would optimize ...continue reading

is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK.


A normal day for Dr. Pierre Pili may involve being helicoptered up to a glacier in the Alps, and then lowered by cable 30m down into a crevasse to assess and treat casualties. Few of us see patients in such a difficult and unforgiving environment but this is Pili’s consulting room. A mountain rescue doctor based in Chamonix, he is involved in about 1500 rescues per year, and when not on the mountain, he works as an emergency medicine doctor.

On his first rescue he was called to help two skiers who had fallen deep into an Alpine crevasse. One was dead and one was seriously injured. Pili talks about the mixed fear and excitement of doing this work ...continue reading

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is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK. He's currently also Chair of the Jury for the National Research Award of the


Swiss primary care research has a very bright future, from what I could see at the early career researchers meeting (TAN HAM) that I attended recently in Bern. put together a superb programme but the key to its success was the commitment and contribution of the researchers. It was their programme and, not only did they present their work with skill and style, and almost exclusively in English, but each research presentation was chaired by one of their peers as the senior academics looked on from the side lines. The presentations were fantastic, covering a range of topics, as described below. But I thought the peer chaired sessions were an innovation worth replicating at other national and international meetings.

Many countries are struggling to recruit and retain a family medicine workforce and Switzerland is little different. ...continue reading