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Janus CPD/CME Scholarships

The CFPC/REF’s Honours & Awards Program offers funding for members to pursue Continuing Professional Development (CPD), Continuing Medical Education (CME), or family medicine research. Recipients can present the results of their programs as poster presentations at Family Medicine Forum (FMF). Here are some highlights of the posters at FMF 2006 November 2-4, held in Québec City.

For information on applications and nominations, please see www.cfpc.ca/awards .

Évaluation des facteurs influençant la succion durant l'allaitement

Dre Julie Choquet, Lachine, QC

L'évaluation de la prise du sein par le bébé soit durant une visite de routine ou lors d'un problème d'allaitement doit inclure un

questionnaire, un examen physique des seins et de la bouche de l'enfant et l' observation directe d'un boire. Certains facteurs anatomiques (ex. ankyloglossie) ou fonctionnels (ex. anomalies du tonus) ayant un impact sur la prise du sein peuvent alors être repérés. Les interventions que nous poserons afin d'améliorer la situation varieront considérablement selon les divers problèmes découverts lors de cette investigation.

Advanced Psychotherapy Training and Nicotine Dependence Treatment Program Development in an HIV Focussed Urban Family Medicine Clinic

Dr. Karen Eva Jones, Toronto, ON

The Janus Scholarship is directly and indirectly supporting my efforts to enhance mental health services for our urban clinic’s LGBT / HIV+ patients. First, it is funding my participation in three psychotherapy CPD programs: an advanced course in CBT; a two-weekend workshop on providing psychotherapy to people with concurrent mental and medical illness (in particular, HIV); a program providing longitudinal supervision and a certificate in psychotherapy. By covering the costs of the aforementioned training, the Scholarship is indirectly supporting

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my (otherwise unpaid) work to develop an on site nicotine dependence treatment program for our HIV+ population.

Selective Use of Bedside Ultrasound in the ED

Dr. John Rizos, Mississauga, ON

The Emergency Department Ultrasound (EDU) has altered the way ED physicians manage selective patients. Focused use of EDU relies on promptly identifying the presence of:

1. Free fluid in the abdomen. 2. A pericardial effusion. 3. An intrauterine pregnancy. 4. An abdominal aortic aneurysm.

Traditionally physicians have relied on time consuming formal radiological evaluations, away from the ED, to diagnose the above conditions. This delay has the potential to adversely affect patient outcomes. Proficiency standards for EDU have been set by the Canadian Emergency Ultrasound Society (CEUS). CEUS requires the completion of an introductory course, followed by a 4 day supervised course in which the candidate identifies 5 key anatomical landmarks in 50 model "patients", followed by written and image identification tests. Successful completion of these courses confers the physician with independent practitioner (IP) status, permitting the IP to employ bedside EDU in the management of suitable patients. Acquisition of IP status to employ EDU in a focused fashion will undoubtedly improve patient care in the ED.

Addressing the Need for Acupuncture Services in Remote Aboriginal Communities in NorthWestern Ontario

Dr. Barbara Russell-Mahoney, Sioux Lookout, ON

There are over 16,000 OjiCree First Nations patients in the NorthWestern third of the province of Ontario. Many suffer from a multitude of acute and chronic pain and neurological problems. To address the need for more services in pain management in the region, a physician in Sioux Lookout is continuing to acquire acupuncture training through Level II of the Acupuncture Foundation of Canada. Acupuncture offers another modality for these patients to choose from to restore balance and health in their lives. In looking at the hierarchy of evidence, clinical experience is demonstrating that these patients are finding that acupuncture is efficacious, helpful and safe. Going up the pyramid of evidence there have been recent valid randomized controlled trials published that have shed more light on the use of acupuncture to treat painful

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conditions. Acupuncture is a valid skill set that may be learned and added to the toolbox of Family Physicians to enhance their treatment options that they offer patients.

Aid Apathy and Africa

Dr Helena Swinkels, Vancouver, BC

Canada accepts some 26,000 refugees per year, a small proportion of the approximately 9.2 million worldwide. Many have harrowing tales to tell and suffer medical, psychological and social consequences of these histories. One such refugee inspired a search to understand some of the reasons that developed nations are reluctant to establish policies that would lead to

meaningful changes in Africa, where 30% of the world's refugees originate; changes that would enable persons to remain in their own countries rather than face the trauma of leaving their homes, families and cultures in order to seek safety in foreign lands. Stemming from the stages of change model quintessential to counselling in family practice, this review of the literature explores the barriers to change in our perceptions, beliefs, values and economic and social structures that prevent us from taking a more active role in addressing Africa’s plight.

Clinical Training in Obstetrics

Dr Murray Trusler, Moose Factory, ON

According to the 2005 National Physician Survey, only 12% of male and 15% of female family physicians perform obstetrical deliveries in Canada. The Clinical traineeship in obstetrics was organized to address this problem at Weeneebayko General Hospital, Moose Factory, Ontario, the province’s most remote hospital. Two younger graduates who had not done many deliveries and two older graduates, who were returning to obstetrics after a hiatus of up to nine years, were involved in the program. Under the tutelage of Drs. Pond and Froats, we spent two weeks refreshing our skills in office, hospital and labour room obstetrics. This proved to be an extremely valuable training experience and facilitated the safe re-opening of the obstetrics program at Moose Factory.

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Going Back To School: How I Am Studying For A Masters Of Science While Continuing To Practice Family Medicine

Dr Michelle Greiver, Toronto, ON

50% of medical services are provided in primary care, but only 10% of research is currently done in family practice environments. Family

physicians often have good research questions arising from their own practices, but may lack time, education, or resources to pursue these questions. I have started to do research as part of my practice for the past several years, as I had questions based on problems occurring in my practice, which were not answered in the literature. I now wanted to obtain some formal training in research methods. This poster will describe how I am studying for a Masters of Science at the University of Toronto, while continuing to practice family medicine in the community. Tuition for my MSc is partially supported by an award from the Janus Research and Education Fund.

Creating a Healthy Lifestyle Clinic in a Multicultural Neighbourhood

Dr. Cleo A. Mavriplis, Ottawa, ON

Context: A new family medicine teaching clinic opened in Ottawa, in August 2006. It is situated in a multicultural, mostly Asian, neighbourhood. I was asked to “champion” a Therapeutic Lifestyle clinic. This clinic’s goal is to take referrals of patients with diseases like diabetes, hyperlipidemia, obesity, and effect change in their lifestyle, to improve their outcome. With my scholarship I spent time learning about motivational interviewing, stroke and cardiac prevention strategies, exercise prescription, diet modification. I hope to use this knowledge, with my multidisciplinary team, to effect healthy lifestyle changes in our community.

Dr. Sheila Lakhoo, Toronto, ON

Dr. Lakhoo is a family doctor in Toronto working with a physician group called Inner City Health Associates, which has over 40 physicians providing quality health care to marginalized and vulnerable communities within Toronto.

Dr. Lakhoo received a Janus CPD Scholarship in 2008 for her Master’s of Health Sciences in Family and Community Medicine.

My main objectives within the program were primarily three fold: 1) To gain an in-depth understanding of global health issues and social determinants of health 2) To better

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understand public health policy and health care delivery systems both within Canada and globally 3) To enhance my mentorship and leadership skills within the area of primary care.

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